HomeMy WebLinkAbout0127959-HVAC (furnace)
G
OSHKOSH
ON THE WATER
Job Address 134 W 17TH AVE
CITY OF OSHKOSH
No
127959
HV AC PERMIT - APPLICATION AND RECORD
Owner DAVID A HOGUE
Create Date 11/27/2007
Contractor
BLACK-HAAK HEATING
Category ~O~:-'3esicL~~!i?L-rIeati~9 ~ Y~,~.!lLaJi~a __ Plan
Fuel 0(3 as 0::011--] 0 Ele~,d~==-~~J O:]ol~~===--=J
System Q,Ne~____~ 0~e:p~~~_____,_______-1
02orcedATr-l DRadT8rit--1 [Tsteam--J ~===
ITETectr:Ic-l U Hot Water J Ouppf'-~ m~~urner J
Chimney Type :. Chimney A ~himney B '____~_Q_ Dir..~!.y~____jJ:i':!()L~ppJicable ==-==
Heat Loss o::_~ Approve~__~--'_ Existing __,__~=~~-=---_O_NotApp_'_i~~Ti=_==] Value
BTU Rate ITl\sf'~LPJ~n-_=_=-=Tr~~ri?~-'--e~-_~- ~.,..'- ~~:-~=~-=~the:r___----- -- , ___ Value
Use/Nature pUPLEXTREPLACCGAS FlTRNACE(onefurnace'sei:VTceboth-tenanCspaces);ET'iTSIGNEO- BY-dlJANTUMELEC'(RICACSOCUtIONS
of Work "'check #16477
D].Olid _=-=~_ '
Other
O-Vent __==]
I
i
_J
Fees: Valuation ___~2,300.0Q
Issued By: 25m s;-
Plan Approval
$0.00
Permit Fee Paid ____..1i4.50
Date 11/27/2007
D~er"2i.t V?jd_e~~
Parcelld # 0305580000
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
PO BOX 7075
APPLETON
WI 54912 - 7075 Telephone Number
-------- ---
920-757-9990
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
REC I
NOV 232007 ~
DEPARTIVIENI dF . ~
COMMUNITY DEVELOP~f;,:N
INSPECfION SERVICES oefMKOfH
ON THE WATIOR
HV AC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~V~.\\ \Ct $ y~ .6D
. 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 varticipatin'Z in the Permit fee Account System and have adequate funds. check here
if you want this orocessed through your account n
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE \ \ \ mD lUl
CONTRACtOR
CHECK 0 ALL APPLICABLE
USE CATEGORY
DSingle Family ~uplex DMulti-Family
DRental
o Commercial
o Industrial
FUEL
.~Gas
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
b{lReplace
TYPE
ftIForced Air DRadiant DSteam DA/C DVent DElectric
IS CHIMNEY BEING LINED DNo)jYes - LINER SIZE 3 \\
Note: All chimneys shall be sized per the BTU's being vented.
DHot Water DSuppl. DCon. Burner
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
'MChimney A
DAs Approved
DAs Per Plan
DChimney B
lS1Existing
DVariable
DDirect Vent DOther
DNot Applicable
mtOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
--A-> 1 r\OtCe erlll (. e
07/07
R
I
ED
~
OJH<OfH
Q!o/ t"J "Ti~
eiay..ro._oI.
OMlill~ or~lI!ln Scniai
Z1SCMftllA......
1'0 ao~ lUG
OJ.....!> WI $4!l!l2-IIJO
O~ '~o-a'.'lm'
F.. jl2O-!3~SOtl4
NOV 23 2007
DEPARTJ\1ENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric Installation Vertftcation
(I) (We) _~Uru\\11m..8e,ttr\C1U ~urrs, LLt.
(Blecnric;:al Contractor ame)
.. gOJ..6JJi 'Ch11. ~~n~Jtt Wi
(Address) (City) (State)
~4Q\
(Zip Code)
have been contracted to perform electric installation walk for
(Name of party contracted t "
at the following address: \ ~Li W ~ l14K\ 5\:. \ ()~ ~.~) . ~
, (Addmls~ed)
The nature oftbe work consists of; (Cbeck One or Describe the Nature of Work)
~
Reconnection or new d<<:uit for replacement Heating Plent and/or Ale Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection ofthe Service Entrance Cable, Meter 80K, alteratioml to rtlC~1ac:lC8 and
llshting fi:'ttures due to siding I soffit installation. Note: New Sel"\lice Sntranca
Cables will require a separate penn it.
R.econnection or new circuit for other permancm.tly wired appuanQeI\ ! fixtures.
Other
~ ...'0
The value of tlUs work is $
-'
r herebyverifjf thia work win be performed by an employee of this company and. further verifY the
rcconneotion I installation will be done in compliance with manufacturer and Electric code
requirements.
J P{:be ~ ~ e+p~$ou
(Print Name of Officer)
III ~o.2
feOa )
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