HomeMy WebLinkAbout0127943-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 412 DOVE ST
CITY OF OSHKOSH
No
127943
HV AC PERMIT - APPLICATION AND RECORD
Owner JANE A MEYER
Create Date 11/27/2007
Contractor
BTU Rate
I\IIARK VI{E~E~HEA Tl~~~ COO!:L~QJ!:! Category 5_0Q_~I3~~icf~ntia!-H~atLng &\'/~.!iIaJing_n
~~~S-:=~-=_~~l D~2~=~==~-'~' O~Electric D~~'iIaT---
D~N~~__n_~__~_~~J 0~epl~c~_____ _ ________j [10theru ___
~ FOr~~~~ O:_~~~C~_:J O:-Sf~~~_~::~:~l D-=~===_=::J
L@~~ ITJ:I~~=-l IT~2eI==J U COr1=~~~~J
O::-g_hlmney A = (1 Chimne~=-~=:==]t Direj:~Ven(--==--:O:-NoC~QPiicable -=_:J
rrAs-APProvea--=-~EXTStiri9-n=:====. NoO\ppJicab~_-===:J Value __________
0_ As J:er PI~n__:_______.O Variable_~~_=-__~_.-otiier-===:===-=] Value
Plan
Fuel
Solid
-""i
System
D:VehT--:~:__j
Chimney Type
Heat Loss
Use/Nature [SFFrl REPLACE EXISTING FURNACE, EIVSIGNED BY EC-ECTRICArCONSfROcfToNSERVTc-ES[[CTGr-egDa-itT$j-'-*de-bCa-ccC---1
of Work ' ,
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Fees: ValUati~L -;::r:: $1,600.00
Issued By: 151-lJ&
Plan Approval $0.00
Permit Fee Paid
$34.00
Date 11/27/2007
o Permit Voided
Parcelld # 1610530000
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
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 (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 ofInspection Services
P.O. Box 1130 .
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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OJHKOJH
ON THF WATFR
HV AC 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 vou are a contractor participating in the Permit fee Account System and have adequate funds. check here
if you want this processed through vour account ~
** 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 //'~b.-t)7
JOB ADDRESS i (~ D O~
OWNER J~.. ~
CONTRACTOR. ,(1J4-r1r/ I"'~
. .~.~L~ IkJc...
.
CHECK ~ ALL APPLICABLE
USE CATEGORY
mmgle Family ODuplex o Multi-Family
DRental
DCommercial
o Industrial
FUEL ~~
DOi!
DElectric DSolid
DSolar
SYSTEM
DNew
OOther
~eplace
TX}>E
~ced Air DRadiant DStearn DAlC DVent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED &0 DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE OChimney A DChimney B ~irect Vent o Other
HEAT LOSS DAs Approved DExisting DNot Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DE~PTION I SCOPE OF ALL WORK BEING DONE R~r- (J)"c eY!~{.
ruvtl'J~\.)"t+ A--~) OA~ -
VALUE (Including labor and materials) $/6 () () "D a
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
,~
07/07
I'O&~ln{\
f)sM:Qsh \Vf 549tn.! ;30
Office 920-13-6-5iJ50
F;!x Q2fr-236-50g4
Electric InstaUation Verification
I (We)
(Electrical Contractor Name)
(Address)
(City)
(''' , r'< '.)
,LIP \_oae
(State)
have been contracted to pelform electric install,aLien ""ork for A~~-~__,iL~_~.,
G~ame of pmty contracted to)
at the feIlovving address: ~qJ ~.__~.._D_Q_0..c_______________~____~___~<
(Address where work will bepeyfi:mllcd)
The nature of the work consists of: (Cbeck One or Describe the Nature onVork)
_,'1::__ Reconnection or new clrctiit for replacement Heating Piant and/or Ale Condenser.
Reeonnection or new circuit for replacement Electric Water Heater or power ven(:ed
\vater heater.
Reconnection of the Service Entrance Cab ie, Meter Box, alterations to rDC(;ptades
and lighting fIxtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate perrniL/
Reconnection or new circuit for the replacement of other permanently \vired
appliances I fixtures.
circuit for the addition of Ale to an individual dl,velhng unit (house or the
individual systerns in a duplex 'or condominium), including n::quircd service
electlica! ouHets.
Other
The value of this work is $._.;t.t2.ll.0U.""..,__.
r hereby verify this work '\-viE he performed by an employee of this company and ftniher "verify
lhe rec<mnection / installation wiB be done in compliance with manufacturer and Electric code
req II i roments.
I /..-~t ~()2
"._~---~-----'--, --<-,-~.
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(Print Name of Officer)
(Date)
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