HomeMy WebLinkAbout0126593-HVAC (boiler)
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OSHKOSH
ON THE WATER
CITY OF OSHKOSH
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HV AC PERMIT - APPLICATION AND RECORD
No
126593
System
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Job Address 1057 VAN BUREN AVE !
MARK WEBER HEATING & COOLl~G IN
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UOil!
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0:. Ra~iant
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ITHot,Water
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() Chimn~y B
() Existing
() Va~iable
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UselNature iSFR 1 Replace boiler. EIV provided by'Electrical Construction Services. **DEBIT ACCT**.
of Work I
Owner
PAUL UKAREN NIEMAN
Create Date 09/04/2007
Contractor
Category 500 - Residential-Heating & Ventilating
Plan
Fuel
~ Gas
~tric U Solar U Solid =:J
o Replace D~t~~~___J
[JSfeam.-.==J U NC~J U Venl~-J
u. Suppl..=:J U~~~J
-.O.I:)J.re~! Vent __~OJ!ot Applicable
Chimney Type
o New
Qorced Air
U Electric
. Chimney A
Heat Loss
KJ As Approved
j() As Per Plan
. Not Applicable ___J
. Other .
Value
BTU Rate
Value
Fees: Valuation
$2,400.00
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Pla'n Approval
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$0.00
Permit Fee Paid
$46.00
Date 09/04/2007
Issued By:
o Permit Voided I
Parcelld # 1607290000
In the performance of this work, I agree to perfor~ all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to en~orce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an eas~ment, 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
AgenUOwner
Address
1075 ISLAND ESTATE CT
OSHKOSH
WI 54901 -1341 Telephone Number 235-1523
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 ofIrlspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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OJHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
An information after bold categories must be provided.
I Incomplete applications will not be processed.
· Application(s) and fee(s) can be prought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Corntnencing work without permit(s) will result in fees being doub~ed or $100.00 plus the
normal permit fee, which ever is ~eater.
OR t
I 'ou are a contractor artici a}in in the Permit
ou want this rocessed throu ih our account
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BUr f;() A ve.-
unds check here
JOBADDRESS ) 0 6 .7 V~y');
. OWNER Arv J ,..V','e,rn 1M/] I
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. CONTRACTOR /V)c. V l~ L..J r2 ~r
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CHECK Ia ALL APPLICABLE I
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DDuplex OMulti-Family
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DElectric 'DSolid
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DSolar :
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DATE '1/ L{ 10 '7
USE CATEGORY
erSingle Family
DRental
DCornmercial
DIndustrial .
FUEL
0Gas
o Oil
SYSTEM
DNew
DOther
f21Replace
TYPE I
DForced Air IZfRadiant DSteam DAlC o Vent DElectric OHot Water DSuppl.
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IS CHIMNEY BEING LINED lifNo DYes - LINER SIZE
Note: All chimneys shall be sized per the ~TU's being vented.
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~Chimney PJ,
DAs Approv~d
DAs Per Plan
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DESCRIPTION OF ALL WORK ~EING DONE Jt'P 10/ Die eYVle-ll1
~, ph 6t A/'e)A} 6Y'?~ v
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DCon. Burner
& MANUFACTURER
CHIMNEy TYPE
HEAT LOSS
BTU RATE
DChinmey B
DExisting
DVariable
ODirect Vent
ONot Applicable
OOther Value
DOther
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~~ IStl ~
b01'/...Gy
VALm I _ $J~OOOQ ?q~
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ELECTRICAL CONTRACTOR.t:0 &, ~~ ~(',d(' S . \ (/\
o For applicable projects, an *ectric Installation erification form, signed by the Electrical Contractor, must be
attached. If not attached or nit applicab~e, a separate Electrical Permit is required.
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9/02
City of Oshkosh I
Division of !nspedioll Servic,~s
215 Church AvenJe
PO Box 1130 I
OsL~osh WI 549(}~-! 130
Office 920-Z36-5(j50
Fax 920-236-5084
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Electric Installation Verification
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1 (VI e) ---t:;;:. \ 'h:^"'J"t. '4 ;"1l- ~\"".r:l<:C)':"~r.1. '\ '} \~,rf,~} . ":~~J} }.. h '=_$'':''1':,,1' \"\*,, ~ f
. (Electrical Contractor Name)
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(Address)
f, ."'~_~ ""~\.... \
~,,,",,- ~~ ',':) \\,...u"'y.., ...,~
(City)
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(State)
&::~<f k 'C:h l~~ "~
<,.J "'1 I',./~'?
(Zip Code)
have been contracted to peh'oml electric installation work for MpJs:-u.g,.k{;..t:.._____,
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at the following address: I~Q.5~ y ---~n....___BU~~lLl2...
I (Address where work will be perfol1ned)
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The nature of the \vork con~ists of: (Check One or Describe the Nature of Work)
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--~ Reconnection hr new circuit for replacement Heating Plant and/or AlC Condenser.
Reconnection hr new circuit for replacement Electric Water Heater or power vented
water heatJr.
Reconnection 6fthe Service Entrance Cable, Meter Box, alterations to receptac1e~
and Iightin,g fixtures due to siding I soffit installation, Note: New Service
Entrance Cables wiH require a separate pennit.>' .'
Recormection 41' new circuit for the replacement of olher pennanently wired
appliances 1 fixtures.
New circuit for[ the addition of AlC to an individual dwelling unit (house or the
individual Systems in a duplex or condominiuf.a), induding required service
electrical Olhlets.
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Other I
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The value of this work is $.l~~' 0 t>
I hereby verify this work wiII! be performed by an employee of this company and further verify
the reconnection I instalIatiori win be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
.::lL~ / -0 7
(Date)
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