HomeMy WebLinkAbout0127956-HVAC (boilers)
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OSHKOSH
ON THE WATER
Job Address 3500 N MAIN ST
CITY OF OSHKOSH
No
127956
HV AC PERMIT - APPLICATION AND RECORD
Owner PERFECSEALINC
Create Date 11/21/2007
Contractor ~l}~_~:LWINT~J:~_~ONS_J_NC ____ Category ~JQ_:lr19-,-~_g~rT1Ill~f:!~ting_&_Ven~i1~tit1_g__
Fuel 2T9~~==:::] IT9J1_n=~~~~= O:~E}~c!ric_-_-~-~J D-~_q!a!~:::=:::::]
System D__N!'l~__________..___J 0__~epl~~________J
O.f~~~ D-Radiant ~ O-Steam -==--=J U A1C~ J
ITII!'l~t~----.-J ~ Hot Wat~_J U Suppl.__=:J ~=-~~~er I
Chimney Type ITgl1~~L~_-=O~~~-==:~-=(}]Tie~~::-:::===.EQ.l~pPliS:~~~_==::::::
Heat Loss IT.A:S-Approved .- Existing - O_-"!.~~~~l~::::=-==J Value
BTU Rate O_~s Per Plan () Variable ___._gth~______u____J Value
Plan
C-_Suo_lid -_-.-=~=:
Other
U Vent
I
____J
UselNature 'COMM / Remove 2 existing hot water flex tube boilers and breeching and replace with 2 thermal solutions boilers'--Ve-iitboilers direcCETVI
of Work ~igned by Suburban Electric "check #523228 I
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Plan Approval $0.00
Permit Fee Paid
$615.00
Date 11/27/2007
O-'=ElI"~~'I!.~idedJ
Parcelld # 1519603301
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 1896
APPLETON
WI 54912 -1896 Telephone Number
-- --.-- .--'.-.--..--
920-739-8881
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-ll30
Phone (920) 236-5050
Fax (920) 236-5084
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OfHKOfH
ON THE WATER
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 particivating in the Permit fee Account Svstem and have adequate funds, check here
if vou want this vrocessed through vour 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.
JOB ADDRESS "3500 '" ~ l~k/l\.J ~l12-gg,-
OWNER '"bc'!lvhS- re;(l.fg-L~4~
CONTRACTOR Ao~U4', Wtt-J.~ t f,O"'Y7, tFG,
DATE 11- (r-Oi
CHECK 0' ALL APPLICABLE
USE CATEGORY
OSingle Family o Duplex OMulti-Family
~/ DElectric DSolid
DSolar
o Rental
LerCial
FUEL
SYSTEM
DNew
DOther
OIndustrial
~ce
DOil
TYPE
DForced Air DRadiant DSteam DAlC o Vent DElectric
IS CHIMNEY BEING LINE~ ~y es - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented,
CIDMNEY TYPE DChimney A DChimney B DDirect Vent W:>ther - l-i~T pA-B
HEAT LOSS DAs Approved ~xisting DNot Applicable ~TAlr-l("C'?~ 4'~
BTU RATE DAs Per Plan DVariable DOther Value
DESCRIPTION I SCOPE OF ALL WORK BEING DONE 12.evY\o\l@(t)G.'1--i4TI~t\ ~OT WA-l"L1L
Fl.-Bj. '1V~g l3DiL.~<7 1'- f??t2e86j.I--UJti. tzepld}Ct6 tv/ 2 T~vW1kL
7c,H..VTl 0"';"7 ~od.a\2-~ ~ \Ii'Et-3T 'PCJILA51'Z,,,? 0 i f2.i16T '" I
/""
~ Water DSuppl. DCon, Burner
& MANUFACTURER
VALUE (Including labor and materials) $ t3 5) 4' if 6 ..~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 6 ~~ A-TT~<::.H~
07/07
600 ~ [CCSL ON X~/XJ.] gO: 91 NOW LOO6/96/11
11/26/2007 13:52 FAX 920 739 4767 SUHUHHAN ~~~rKIC
I{GJ UU;S
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Cily orOsbk.lMb
Divis/all Df hl"l'cetlDII Services
215 O.urch Av,,"ue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 92D-2J<s-snl\4
Electric Installation Verillcation
I (We)
,9ti. biU Vti J ] f., II/h-j{J
(Electrical Contractor Name or Homeownerts Name)
itfl \\t~t1i\l-l1ji)Y) Li:l ~Cl ")
(Address) ( 'ty)
\I\\J
(State)
sL/0JLj
(Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
2,SDL' N. \\'\(~\(\ ~+-cev ~
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nat.ure of Work)
L Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser,
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations 10 receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit fol" the replacement of other permanently wired
appliances l.:fixtures.
New circuit for the addition of Ale to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi-use building would require a licensed Electrical
Contractor,
Other
The value of this work is $
I hereby verifY this work will be performed in compliance with the License requirements of
Section 11-22 ofthe Oshkosh Municipal code and further verify the reconnection / installation
will be done in compliance with manufacturer and Elect.ric code requirements.
II-zit -tJ'7
(Date)
07/07
600~
VN '1VHS;)Hd~Hd
600LCOC066 XVd gS:91 NOW LO/96/11