HomeMy WebLinkAbout0126499-HVAC (furnace; a/c)
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OSHKOSH
ON THE WATER
Job Address 1585 DEERFIELD DR
Contractor VANS HEATING & AlC INC
CITY OF OSHKOSH
126499
No
HV AC PERMIT - APPLICATION AND RECORD
Owner ROBERTNlRGINIA C HATHAWAY
Create Date 08/28/2007
Category 502 - Residential-Both
~tric .~
o Replace ___
U Steam ~
OSuppr:-i
U Con. Burner J
Plan
Fuel
U Solar
~Gas---==J
OJ'Jew
System
Chimney Type
~rForced Air l
ITElectric 1
U Chimney A
UAs Approved
IT~s Per Plan
Heat Loss
BTU Rate
UOil
~ illolid 1
~her ___~
I U Vent 1
--~
~ AlC
U Radiant
U Hot Water
o Chimney B
. Existing
. Variable
. Direct Vent
() Not Applicable
~ Applicable
I
Value
() Other ---=-== Value
Use/Nature [SFR / REPLACE FURNACE AND AlC UNIT, EIV SIGNED BY CSI ELECtRIC
of Work I
l_
Fees: Valuation $6,200.00
Issued By: ~
-----1
I
I
I
_ __________~__________________________J
Plan Approval $0.00
Permit Fee Paid ____________~_1.94.S.Q
Date 08/28/2007
o Permit Voided I
Parcelld # 1320050000
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, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
~
OfHKOfH
ON THE WATER
AUG 2 g 2007
DEPARTMENT OF
COMMUNIn' DEVELOPMENT
INSPECTION SERVICES DIVISION
HVAC PERMIT APPLICATION
All information 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
lfvou are a contractor lJarticilJating in the Permit fee Account System and have adequate funds. check here
if VOll want this lJrocessed through vOllr account n
JOB ADDRESS ts<i5"
OWNER \jiv~~{)\Q
CONTRACTOR '\/ ~
Oee(~ e\d \dr
\\~a tlJ~
\kuJ,~ _
,~
DATE <61 &'-1 J 0,
CHECK 0 ALL APPLICABLE
USE CATEGORY
1jtsingle Family DDuplex DMulti-Family
o Rental
DCommercial
o Industrial
FUEL
~as
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
~Replace
~YPE
JOforced Air DRadiant DSteam DAlC OVent DElectric DHot Water DSuppl.OCon. Burner
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CIDMNEY TYPE DChimney A, DChimney B ~irect Vent DOther
HEAT LOSS OAs Approved .~ ' !;6Existing ONot Applicable
BTU RATE DAs Per Plan ij)Variable DOther Value
(
DESCRIPTION OF ALL WORK BEING DONE1Q{2IOb trr/U1-eO" A.c-
VALUE (Including labor and all materials including light fixtures) Lllda)' to
ELECTRICAL CONTRACTOR
OR ~Iectric Installation Verification form attached(IfReplacement)
Electrical installation o/new/replacement equipment shall be done by licensed contractors
(JP-^ ~ \- ~ ~ m S::>
3/02
FROM CONCEPT SERlJ ICES '
FAX NO. 920-336-8697
Mar. 18 2003 03:01PM Pi
RECEIVED
~
O~g7H
(I!J uu VI," t2
Ciry of ~~Q.~h
Divisit}rl (lfln.spectiol'l ~rvi<;cs
215 Church AY!:I1l1C
PO Box 1130
Oshlcosb WI 54903.113G
Ofrocc- 920-236-5050
Pax 920-2.36-5084
AUG 2 8 2007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric Installation Veriflcation
w' 54 II S-
(State) (Zip Code)
have been contracted to perform electric installation work fOT I/ftl"}.5 1J.~II..kyt (} f C(pL~v'o.3
(Name of party contracted to)
~eyr-RR \cL W
(Address where work will be perfonned)
4033
(Address)
C'(]vl (r?fJf ~5r2el/I(r?~
, (Electrical Contractor Name)
JJe IkRe J
I (CitY) ,
r Y) G, (C5 i elQtivk.->
I (W e)
H k.Jy .5'7
at th~ following address: ls=6S
At ..
The nature of the work consists of: (Check One or Describe the Nature of Work)
-A Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconnection or new circuit for replacement Electric 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 req~ire a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances I fixtures.
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a duplex or condominium). including required service
~~~_~~__,_ele_ctric.al..outlets,:.,-..___~____,__~______--.,-._~~so-==-,,,~,:_,,.<,<0',j"""'''"''<'-'~'','''9,"",,,-;''''o,;';;''''i''''i;,.'~,_~_..~~~,."....,....-"
Other-' -
The value ofthis worlds $ JOO,OQ .
-I hereby verify this work will be perfonned by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Ele,ctric code
requirements.
(Signature of Company Officer)'
:PAL-!;' d :JbRQu
(Print Name of Officer)
~
(Date)