HomeMy WebLinkAbout0126647-HVAC (boiler)
.
OSHKOSH
ON THE WATER
Job Address 653 MONROE ST
CITY OF OSHKOSH
No
126647
HVAC PERMIT -APPLICATION AND RECORD
Owner F JEANNETTE WAGNER
Create Date 09/07/2007
Contractor A-1 HEATING & AlC INC
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant
U Electric ~ Hot Water
Chimney Type D Chimney A C) Chimney B
Heat Loss C) As Approved . Existing
BTU Rate :0 As Per Plan o Variable
Category 500 -Residential-Heating & Ventilating Plan
I I Solar U Solid
o Other
U AlC U Vent
I j Con. Burner
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent . Not Applicable
() Not Applicable
. Other
Value
Value
80,000
Use/Nature Duplex I Replace boiler. EIV provided by Bell Electric.
of Work
$4,600.00
~(XJ
Plan Approval
$0.00
Permit Fee Paid
$79.00
Fees: Valuation
Issued By:
Date 09/07/2007
o Permit Voided I
Parcelld # 0405530000
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 (Le. 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
(t)
OfHKOfH
ON THF WATF.R
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
If you are a contractor varticivating in' the Permit fee Account System and have adequate funds. check here
if you want this vrocessed through VOU1. account n
DATE f/J-~I 07
JOB ADDRESS 653 }110~1lf'v~ .s.t {}slJl1o;h
OWNER V~an -e1-,e wPb'"."r :2.J~- J 7QS
CONTRACTOR /1..../ H-et:J;~J ~ //1(. (vA ~idr()nl;J. .-1:""-(
9)i;/~ 779- ?'i3 i?
CHECK ItI ALL APPLICABLE
USE CATEGORY
OSingle Family ~uplex OMulti-Family
ORental
OCommercial
OIndustrial
FUEL
rYGas
BOil
OElectric OSolid
oSolar
SYSTEM
oNew
oOther
'l9keplace
TYPE
OForc~d Air ORadiant DSteam ONC oVent OElectric ft"Hot Water OSuppl.DCon. Burner
IS CHIMNEY BEING LINED b'No DYes - LINER SIZE
Note: All chimneys ,shall be sized pef'the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
OChimney A
OAs Apnroyed
"'~A..s Per Plan
Oc;hirnney B
UlExisting
OVariable
ODirect Vent ltfOther /VL.
ONot Applicable
OOther Value
ED
DESCRIPTION OF ALL WORK BEING DONE
/J~~~
SEP 7 2007
V ALUE (Including labor and all materials including light fixtures) $
~ 6,-'0 < (/0
-
DEPARTMENT OF
COfJ\f-1UNTIY DEVEI..OP~1ENT
INC:;PFCTION SERVICES DIVISION
(')9' tJO
ELECTRICAL CONTRACTOR ~t? [L OR 0 Electric Installation Verification form attached(lf Replacement)
Electrical installation of new/replacement equipment shall be done by licensed cOlltractors,
,*6 #>- 31'i''7 /J4 11 '11
09/Q5/2001 WED 6t45 AX 920 133 2713 WAT~ERS PLU~ING
!2I004/0C8
~
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r. 'l' ~(O~IWI\'II
o ".oil M\'lIph't1tlft Sen'''f'
11 tll""'h "'~QC
, eo- lilt'
o \<,..1, WI ~~.)) .1I~~
(J ~'~.13f>.~O'\)
~ 'In.'I..SO~4
Electric Installation Verltteatlon
I (We) _'_ {1g,..L~ ..... ...f!: l ~e."" 1'; "" .
(P.lec\ricn) Cuntractor Name)
I
i
I
!
l:?..:.._...Ao1..--1.12 .~._J1~~4.~h~__~L--- S'yr,$ '2.
{Addr 5S) (City) (Slate) (Z,V Code)
hiJ\'C bctm c:mltr c{c<l \0 perform c.\c<:trlc mSlall.lltion work for A-I Hell rf,~ tJA 11",--,
). ",-... 3 7'5 (Name cfparty W111ractr to)
J'-e~/H"t:t.f._W~~r 653 /flvfIIV'r;-t ~ T 4' ItfS~
(A.ddr~~work. will be perfotm~) .
111~ nal\lTe: of 1 c work c:onsi sts of': (Check One or Ocs~ribe the Nature of Work)
R connQ:tion or new ~\rcuit for rr:l'lncenlcnt Heating Plant and/or Ale CO~det13er.
R cOMedj on or new s:.ircntt ror repla<:emont Electric Water Heater or l'C)Wf Vtl'ted
water heater. '. i
R onnecsion oftl1c S~rvi<.:e EtllranCe Cable, Meter Ba~l ah$'6tions to ~ptaCbl'
111'0 lighting fixtures due 10 flidin& I soffit installation, Net!:: New SerHce
l:::ntrallce Cable~ will require a separate permit. \
R .connection or new circuit for lh.e replacement ofOtl1CT pennanently wit1d
appl ianc~s I fixtures. I
N ~w cirelli I ror the ad<\ition of Ale to a[l indtvidurJI dwelling ut1il {h.ouse dr the
individual systems ill 11 ullptex or cundomini.um}, Including requhed t1~rv1ce
dectnCt\lolltlctS. i
() ner i
I
j
\
.... ----~ ....-
I'"
rh~ vallie \)f I is work is $...
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I hCI'l'by veri r
lh~ rect.mn~'CI'1
n:l.t(lll'(!'m:IlI~.
,
lhis work wi It he petfonned by an employee Qfthis c('lmp~my and f\1rth~r ....eriry
11 f ins\"lla\ion wi11 be done in c02npliW'\c~ with ma.nu.f~turer and Eh:ct~c code
i
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(D1\ e)
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lSlgn:llu.n~ 0 ('Ott\\HU1Y Officerl (Print Name of Officer)
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