HomeMy WebLinkAbout0126202-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 1420 SOUTHLAND AVE
CITY OF OSHKOSH
No
126202
HVAC PERMIT - APPLICATION AND RECORD
Owner MRlMRS KEITH M NOWAK
Create Date 08/10/2007
Category 502 - Residential-Both
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
Plan
Contractor COMFORT SOLUTIONS LLC/ONE HOUR
Fuel l!':J Gas UOil
System IJ New
l!J Forced Air U Radiant
U Electric LJ Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss D As Approved o Existing
BTU Rate D As Per Plan () Variable
U Solar U Solid
D Other
l!':J AlC U Vent
I I Con. Burner
() Not Applicable
. Not Applicable
. Other
Value
Value
Use/Nature SFR / Replace furnace and a/c. EIV provided by Comfort Solutions. "DEBIT ACCT*'.
of Work
Fees: Valuation
$5,882.00
(hnK;
Plan Approval
$0.00
Permit Fee Paid
$98.50
Issued By:
Date 08/10/2007
D Permit Voided I
Parcelld # 1609820000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address
2230 MAIN ST
GREEN BAY
WI 54302 - 3714 Telephone Number (920) 982-3323
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City or Oshkosh
Divisiol1 ot" I nspectioll Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phon~(920)236-5050
Fax (920) 236-.5084
(t)
~QlR.
HVACPERMIT APPLICATION
All infonnationafter bold categories !'l1ust be provided;
lm:omph:lc l1pplication~ will not be processed.
· Application(s) and fetes) \..~an be brought to City Hall, Koom 205 or mailed tolnspect.ion Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $1 oO.no plus lhe
normal permit fee, which ever iN grealer. .
OR
.lfvQlI ar~ a contractor oarlicipaline-JIJ. ~!le 1'(~nJlil
;ivou wallt this {Jr:JJ.pl!.~'si!d throuflh l;our ac..(;.fJ.~lJ.t.
** Advisoty' . Fur appl.kable projects, an Electrical Installation Vel'mcation (EIV) form, signed by the E.h::ctrica1
Contractoe 01" Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted witbollt an EIY when such is required~will not be
processed fot Permit Issuance and will be returned foe completion.
.DATE~
JOBADDKESS \~<...O ~~\CU\t ~
OWNER L:'\ n d. ~ ~ ~illo..i:::-.
CONTRACTOR ~~-\- So\,^-~U"'\S.
CffECK 21 ALL APPLrCABI.F.
~E CATEGORY
)Q.Single Family ODuplex
o Multi-I'amily
o Rental
DCommercial
Olndustrial
FUEL
~Ga'l
OUi.1
DElectric OSolid
DSol1l1'
SYSTEM
ONew
DOther
isiReplilCe
TYPE .
,RtF-oreed Ail' o Radianl OSte",m ~/C OVent OEleclrk DHor Water DSuppl. Oeon. Burner
IS CHIMNEY RF,ING LINED ~o DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be;: sized per the BTU':> being vented.
CHIMNEY TYPE DChimney A DChinmcy R ~jrect Vent DOther
H[AT LOSS DAs APPl'Ovl;lr.1 DExisling ~ot Applicable
BTU RATE DAs reI' PI",n DVariable. ~ther Value . 70 ~
DESCRIPTION I SCOPE OF ALL WORK BEING DONE ~ \~-r
~M.\) qS;~O .- ~ Fu.r~().<:..L
~_sc... \3 ~o - _~_____ ___. __ A Ie
,
V ALtJli: (Including labor 811d AIl~lcriuls) $ 588'.;1.
":LK(~"RICAL (~ONTRA.CTOR (for projects not requiring an EIV Form)
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Electric Installation Verification
1(W.)-1\'\.\~~ VY\.\I\~1 -- ~~
. .... (Electrical Contractor Nam~ or Horn "wner'sNamc)
9(9 q . (,0 ~~O-f- d
(Address)
li) ~~
."1 (City)
~I-
l .
(State)
5'1311
(lip Clllk)
acceptlhc responsibility to perform the electric work as sLated below, at. the following address:
~
\ ~ 2-0
~lA- '-\l. \GUV!
(Address where work will be performt:u)
The nalure of the work consists of: (Check Om:; ur Dcscribe the Nature of Work)
. E Recollnection (II" new circuit for replacement Heating Plant and/or' Ale COf1de;:n::;cr.
Rcconm.;clion or new circuit for replacement Electric Waler I-kaLer or power vented
water heater_
Reconnection of the Service Entram:e Cable. Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit instalJatjon. Note: N~w Sc:rvicc:
Entrance Cables will require a separate permit.
Reconnection or new circuit tor the rcpla~cm~nL of olher permanently wired
appliances I JixLures.
New circuit for the addilion of Ale to all individual d'rl'c/linx unit, including
requircd service electrical outlets. Not/?: Humeuwners (;un on(y do their own
electric on Q single./i,mi(V owner occupied home. Wt.Jrk on (J. cundominiu.m"
dllplex, rentaL, or rnulli-use building would require a licensed E/<!Clrical
Contructur.
Other
The vulue of this work is $ 0
1 hereby verifY this work will he performed in compliance with the License requirements of
Section 11-22 ofth,.; Oshkosh Municipal code and further verify the recol1l1ection / installation'
wHl be done incompliance wit.h manufacturer and Elcctrh; codc rC4uiremcnts.
MlJJ c:.. ~ AA-f ~ ~ if
(Prinl Naml:)
?; !Iu It?. ,
(Date)
fJ7107
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