HomeMy WebLinkAbout0126421-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 1136 S WESTFIELD ST
CITY OF OSHKOSH
No
126421
HVAC PERMIT - APPLICATION AND RECORD
Owner TIMOTHY GRAND/CARRIE BATZLER
Create Date 08/22/2007
Contractor VANS HEATING & NC INC
Fuel l!:J Gas UOil
System D New
l!:J Forced Air U Radiant
U Electric U Hot Water
Chimney Type ~) Chimney A o Chimney B
Heat Loss D As Approved . Existing
BTU Rate ~) As Per Plan . Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
U Solar U Solid
D Other
U NC U Vent
U Con. Burner
() Not Applicable
C) Not Applicable
() Other
Value
Value
Use/Nature ~FR / Replace furnace. EIV provided by CSI Electric.
of Work
Fees: Valuation
$3,625.00
~/O
Plan Approval
$0.00
Permit Fee Paid
$65.50
Issued By:
Date 08/22/2007
D Permit Voided I
Parcelld # 1309530000
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
525 BUTLER ST
DEPERE
WI 54115 -5426 Telephone Number 920-336-2816
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 of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
All infonnation after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
J
if YOU want this processed throu'i!h your account
check here
JOB ADDRESS
OWNER ~.
~
9-~\-fi t\
()~
DATE~
CONTRACTOR
oj!
'\"l~~'
CHECK 621 ALL APPLICABLE
USE CATEGORY
~ingle Family DDuplex DMulti-Family
DRental
o Commercial
DIndustri~il
FUEL
4dJas
flail
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
)dReplace
TYPE
~orced Air DRadiant DSteam DAlC DVent DElectric DHot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LINED~o DYes - LINER SIZE & MANUFACTURER
Note; All chimneys shall be sized per the BTU's being vented.
CIDMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
~irect Vent
DNot Applicable
DOther Value
DOther
DChimney B
~xisting
~ ariable
DESCRIPTION OF ALL WORK BEING DONE 'f ~\a.~1
~UN~lL
VALUE (Including labor and all materials including light fixtures) $ i~ JS' ()::)
ELECTRICAL CONTRACTOR
ORi- Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
" US,3=)
3/02
FROM CONCEPT SERlJ ICES .
FAX NO. 920-336-8697
Mar. 18 2003 03:01PM Pi
~
OiH\Q7H
(ItJ ll-l! VI), 12
Ciry t>f~)1l(Q.~h
Division OrlllSjltCtioll ~1Vi,~s
215 Church A~uc
PO Box 1130
Oslllcosh WI 54903.1130
OIT~ 920-236--5050
Pax no-236-5m4
Electric Installation Veriflcation
I (We) C'r~h1 ( (? f) f ~5(? fVI C r?..5 Inc., I~, e~C
. (Electrical Contractor Name) .
403.3 H wi .5'7 :JJe #Re / WI 54 If 5""
J . <
(Address) (City) (State) (Zip Code)
\
have been contracted toperfonn electric installation work for 1/11-113 IJtJllfllt 9 f- ((J?L{V'l3
(Name of party contracted to)
at the following address: J\ ,3l~ ~ tJ.. JQS;\ -\ie \d~. .
(Address where work will be perfonned)
The nature of the work consists of: (Check One or Describe the Nature of Work)
~ Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconnection or new circuit for replacement Elec1ric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable> Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will :r:eq~:ire a separate permit. .
Reconnection. or new circuIt for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a du.plex or condominium), inc~uding required service
-ele.ctrical...out1ets.:c-~.._______.___..___~""_.__.............,.~~--:::=<=",",-_,.,.,,,:~,:,'1~,,,,~,,"&;.i";,,,,,~,,,,=,"";;;;;'7j;;;C-';':C:-c,,,""'?'~""""""'~
Other '--.. . .
The value ofthis worlds $ JOO.GO .
-I hereby verify rhis work will be perfonned by an employee of this company and further verify
the recolmection / installation will be done in compliance with manufacturer and Ele.ctric code
requirements.
(Signature of Company Officer) .
J)Au; d Y:JRoJ
(Print Name of Officer)
~ 1 G70 ll)t
(Date)
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