HomeMy WebLinkAbout0126643-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 93 EVELINE ST
CITY OF OSHKOSH
No
126643
HVAC PERMIT -APPLICATION AND RECORD
Owner GAIL L PALECEK
Create Date 09/07/2007
Contractor A-1 HEATING & AlC INC
Fuel I~ Gas UOil
System o New
l!J Forced Air U Radiant
U Electric U Hot Water
Chimney Type KJ Chimney A () Chimney B
Heat Loss KJ As Approved . Existing
BTU Rate K:) As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar
U Solid
o Other
U Vent
I J Electric
R'J Replace
U Steam
U Suppl.
U AlC
I I Con. Burner
() Direct Vent . Not Applicable
() Not Applicable Value
. Other
Value
60,000
Use/Nature ~FR / Replace furnace. EIV provided by Bell Electric.
of Work
Fees: Valuation
$1,687.00
Plan Approval
$0.00
Permit Fee Paid
$35.50
Issued By:
~
Date 09/07/2007
o Permit Voided I
Parcelld # 0804830000
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
W8078 HILLCREST CT
HORTONVILLE
WI 54944 - 0
Telephone Number 920-779-8838
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~
OfHKOfH
ON THF WATER
· 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
nonnal permit fee, which ever is greater.
OR
I ou are a contractor artici atin in' the Permit ee Account S stem and have ade uate unds check here
if you want this processed through your account n
JOB ADDRESS 93 /3veLj~e
OWNER {~I L Ptt l~t eP\
CONTRACTOR I; ~I H -eCJi~J q-...
DATE
~/ J-~ 7
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tS/-J6Io
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9Ji.'}"~ 77~- i''i3 if'
CHECK ~ ALL APPLICABLE
USE CATEGORY
~Single Family DDuplex
DMuIti-Family
DRental
DCommercial
o Industrial
FUEL
I1Gas
DOi!
DElectric DSolid
OSolar
SYSTEM
ONew
o Other
~eplace
TYPE
9&orc~d Air DRadiant OSteam ONC oVent oElectric OHot Water oSuppl.OCon. Burner
~~:;:~~~~~~~~~~;s~~~~e~oBr;J~~e~n~~~~lZE & MANUFACTURER
OChimney A
OAs Apnroyed
PAs Per Plan
DESCRIPTION OF ALL WORK BEING DONE
CHIMNEY TYPE
HEA T LOSS
BTU RATE
OChimney B
WExisting .
OVariable
DDirect Vent i}tOther IVL-
DNot Applicable
DOther Value 0 () J' (,'0 c.J
,
SEP 7 2007
VALUE (Including labor and all materials including light fixtures) $
/lbEJ'V~
DEPARTMENT OF
COMMUNTIY DEVELOPMENT
INSPECTION S~ES DIVISION
~3J.
ELECTRICAL CONTRACTOR
fJ;e if ~
OR 0 Electric Installation Verification form attached(lf Replacemenl)
Electrical installation of new Ire placement equipment shall be done by licensed contractors.
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09/0S!2Q07 WED 6:44 AX 920 733 2713 WA'1'!1'ERS P1.UKIUNG
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Electric Installation VerlficatJou
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(StalO} (~(P Code)
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(Name ()fparty ContT8c1~ 10)
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-~q U- -'!.l>j L #c 't f( 93 Pve L/If t J t ()r ~_If't "
(A.ddress where work will be ~rfQtmed) I
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The natUte of I work consists of: (Check One or Describe the Nature of Work) I
R connectiOJ) Qr new circtlit tor replncement Hea.ting rlant and/or Ale Co~<Ienger.
R connection or new cirellir for replacement Electric. Water Heater or P;f. vented
wl!ltc:r he:AteJ'.., .
R connecti on 0 "the St:rvice Entranee Cabl~, Meter a01<. alteratiDttS ID r tados
and lighting r;xtures due to RidinS I seffit ;mtl!Uation. Note: New Se ic~
Entranee Cabh:s will require a scpnralc permit. I
R conncction or new circuit for Ih.e rephu:.tznent cf other pem'lanently wir1d
appli4nccs I fbctures. I
N w circuit fot" tht! addition of Ale to ~1f1 indi\liduaf dWf:lting linit (hollS!:: or the
illclividu~ll systems in I) dllplc.x or condominium), incltJding required IJJvice
clcclricll[ OUUCls. I
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I herC'hy vC'rify Ihis work will he (>Cl'fonned by pn employee oFtbis company and fUf'tlael...erify
II,.... r:-cOllllcctio \ J insll\lInliof' will be done in compUUllcC with manufacturer and Electric code
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(Electrka I Cootnlcfor Name)
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(Addr ss) (City)
h:wc hc~n Ctlnl actetl to perfonn <:Ic-ctric imUaHation work for
IS/-IIIO
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The value Uflh !i work is $..
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(Sl!~nllllJri: 01 C0ll11M1lY OffcCC1') (Prhl[ Namc()fOfficCT)
,. .3$133
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