HomeMy WebLinkAbout0127642-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 1224 WAUGOO AVE
CITY OF OSHKOSH
No
127642
HV AC PERMIT - APPLlCA liON AND RECORD
Owner JOHN W/RUTH E BUSS
Create Date 11/05/2007
Contractor VAN? HEATING & A/G~____ Category ~g~B~~idefl.!!a~:J;eatin.9.~ Ventilatiflg__
Fuel L~L~a~==~] D<?i1 =:::=J DJ~rfc:E-~::==:J D:S~i=:~=-=_=J
System ~~~__________ __J [~L~E?Pla_~~__~_________J
~~-9~~d7~ir J D:~~~ant -=J [T~~:a~=~=-=J D-=~~===:::==J
Q-!=~~i~=] Df:T~=~al~~:_J D~_s~per:=-==] D:g()ri~_~uX~~~]
Chimney Type __Chimney A u-chiml1eYB-------~~~~J::I.!.!o~pp~~ble---_=_J
Heat Loss L...:t~~~cL__.~L____ Q~t Applicable J Value
BTU Rate rr.i\~j~_--=O Variable -~:=-=-==--=-=.-Q!!1~----__J Value
Use/Nature ISFR / REPLACE FURNACE, EIV SIGNED BY CSI ELECTRIC "check #40938
of Work !
Plan
D_~:<lII~--::: .. _J
Other
D_~e~t --:=:=::J
____________~Q,gQO
--_._._---------~----.......,
,
I
i
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Fees: Valuation $2,041.00
Issued By: ~--
Plan Approval
$0.00
Permit Fee Paid _________~,4.1_.50
Date 11/05/2007
o Permit VoidedJ
~-----_._.-
Parcelld # 0204640000
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
DE~~~___ WI_ 541_~... 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 (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, VVI54903-1I30
Phone (920) 236-5050
Fax (920) 236-5084
RE~~~~ED~
DEPARTMENT OF OfHKOfH
COMMUNITY DEVELOPMENT ON THE WATER
HVAC PERMIT APPEmrMI{5~ICES DIVISION
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 ou are a contractor artici atin in the Permi!-L,ee Account S stem and have ade
if vou want this processed through ;our account U
DATE 11/.101
check here
JOB ADDRESS_( an 4 \J Jo u)l t)()
OWNERJUj.ln 1)u ~ ~
V f'l \n ,,\
CONTRACTOR .lL1.:o tKctnflvG /
~
4\~
...
CHECK 21' ALL APPLICABLE
~E CATEGORY
~ingle Family DDuplex
OMulti-Family
o Rental
OCommercial
o Industrial
FUEL
~as
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
)aRep1ace
TYPE
\fftorced Air DRadiant DSteam DAlC DVent OElectric DHot Water OSupp1.DCon. Burner
IS CHIMNEY BEING LINEDtz9No DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CIDMNEY TYPE
HEAT LOSS
BTU RATE
1ffChimney A
DAs Approved
DAs Per Plan
DChimney B
f2i1Existing
DVariable
DDirect Vent o Other
DNot Applicable
" f.}l0ther Value 'J OICO::::::>
DESCRIPTION OF ~ffcl BEIN~~NE .
) {e ,)1.a~R-
ELECTRICAL CONTRACTOR
-cD
VALUE (Including labor and all materials including light fixtures) $ OloY l
OR i!Electric Installation Verification form attached(If Replacement)
Electrical installation ojnewlreplacement equipment shalf be done by licensed contractorj
~fu')\-
y~-e__ ~~\'~
3/02
FROM CONCEPT SERV ICES .
FAX ~O. 920-336-8697
Mar. 18 2003 03:01PM P1
, REC'EIVED
.~
OA-KgJH
(lId un WA l2
City of<n~~~h
DivisiOn O(fllSJleCUOll Services
215 Chlll'llh A~ue
POBox 1130
Oshkosh Wl 54903-1l:l0
OffICe 920..236-$050
Pa); ~20-236-5084
NOV 05 Z007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric Installation Verification
wI 54115""
(State) (Zip Code)
)
have been contracted to perfonn electric installation work for l/PrYi5 1J.t?;ltl',A. (} .;.. ((pL!,'Y1!J
(Name niparty' contracted to)
at the following address: J aa 1-\ ~:li1U,(]"ro qvG ..
Address ~e work will be performed)
4033
(Address)
C"rJYl ((?j)f ~5qfl/I(~-5
. (Electrical Contractor Name)
:VI? #Re J
I (CitY) ,
. Inc' lCJI
~/ed-r1c
1 (We)
H /,Jt ,5'7
U ,,?
The nature of the work consists of (Check One Or Describe the Nature of Work)
-A
Reconnection or new circuit for replacement Heating Plant andlor Ale Condenser.
Reconnection or new circuit for rep lacem.ent 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 wiroo
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
electricaLoutlets.__._.__^__~__~_~_
Other
.. ~.. -.~u..,.;._---!:,~.:.t1!."L.....h.~.!T~~~~;;:A'4,;Ji)=t.~.,;;~;;.;'};'7';;.l"~~
The value of this work is $ JOo,OO ~.
-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 E~e.ctric code
c51:D~
(Signature of Company Offiber) -
J)Av;'d JORQu
(Print Name of Officer)
~
(Date)
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