HomeMy WebLinkAbout0127944-HVAC (furnace)
G
OSHKOSH
ON THE WATER
Job Address 22 STERLING AVE
CITY OF OSHKOSH
No
127944
HV AC PERMIT - APPLICATION AND RECORD
Owner MARY ELLEN ZELLMER
Create Date 11/27/2007
--~.._,-,-.-
Heat Loss
OuOil------
.._~__J
O..1'l~":'_____u______.J ~~~.c;~_._________J
[![Forced;c.:rr-] D~==:J D--St~~~=:=--] D_~C=-==-~==]
IT U l 0 1 D., . Con-.-Su-r.-rie.r..'_u1,'
.... ~Iectric _.. Hot Wat~r:==.J:~_UE)~=~_=:=~ _____mm
(jChimney A -OCh'imney B -:=.... DirEic~~=-_O Not~pPI~~~_:_:=J
D As Approved OEXfStjng-========._.1'J_0_6Eelicab!~_::==J Value
ITAs Per Plan () Variable_'=:=:=---"--6~----'==] Value
Category ~_O.9_.::J3..El.sideJl.tl~I::.H..El.atit1g.~YentilaJit1!L_._
O:]:J~~!fTc'__-.J U._Sol~r-=_===]
Plan
Contractor
MARK WEBER HEATING & COOLING IN
Fuel
L~L~~====
D~Soli9_==:n= "l
System
Other
0: Vent U:.==1
Chimney Type
BTU Rate
Use/Nature ISFRlREPLACE EXISTING FURNACE, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICESTLC(GregDavTsf**deblaccC ---1
of Work:
~S:eUs~d :::uati~~90.QO
Plan Approval $0.00
Permit Fee Paid
.. .$~~.O.Q
Date 11/27/2007
D.!'.erni!~Y9~d~~J
Parcelld # 1001200000
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
_.__QSI::lKO~_ ~_. ~4901. -1341
Telephone Number 235-1J5?~_._.___.
.
Address
1075 ISLAND ESTATE CT
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. 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, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ON THF WATFR
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
I vou are a contractor artici atin in the Permit ee Account S stem and have ade
ou want this rocessed throu h our account
** Advisory - For applicable projects, an Electrical Installation Vermcation (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE / /-7d .-6 ')
JOB ADDRESS O<.~ ~ SJ::z=:nJ- f u.b
OWNER /0/. .. 2...F7 ~-rL
CONTRACTOR~~/tJ.e~"t-~ ~4 r"~JCr
CHECK 21 ALL APPLICABLE
USE CATEGORY
p;asingle Family o Duplex DMulti-Family
DRental
OCommercial
o Industrial
FUEL
r5Gas
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
rKReplace
TYPE
~orced Air DRadiant DSteam DAIC DVent DElectric
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
DRot Water DSuppl. DCon. Burner
& MANUFACTURER
CHIMNEY TYPE DChimney A DChimney B ~irect Vent DOther
HEAT LOSS DAs Approved DExisting DNot Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DJ$C. RIPTlON !-l'COPE OF ALL WORK BEING DONE:P''EP'-~-eJ'\fJ O~ ~ t<;,.,.u;.
~f\.wAe-:e.. ~ \-n-+- A .^~ ~~
VALUE (Including labor and materials) $ /6 ()i) ~60
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07107
i{
~
}.
Cily fir O;hl;o;;!l
ni\'is~o{. i)f ~n$p~tk,;n St:r"it:'t:5
215 Clmn:h /\'!,'rm'~
P08,n 1 UO
Osh;:t1Sh \V{ S49'tB-i i3f1
Offke 920<:36--5050
fa~ <}20- :B<.>. 50&4
Electric Installation Verification
I (We)
(Electrical Contractor Name)
have been contracted to perfbrm electric instaUation vlork fortiAfLl.{_.~___zb...~_.._)
(Name ofparty contracted to)
at the foHowing address: ~~__~_3 ~..;:;'.l..s;).__._---~-_....._-_._.._.._-~---_.
(Address where work will be ,perfoDned)
The nature anhc work consists of: (Check One or Descrihethe Nature ofVlork)
_.K Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconn.ection or new circuit for replacement Eie-.;tric \Vater Iicater or power vented
water heater.
Rcconnection of the Service Entrance Cable, Meter Box, alterations to rcceptades
and lighting fixtures due to siding / soffit installation. Note: No\-\' Service
Entrance Cables \-",'ill require a separate permit..'
Reconnection or no;"! circuit fix the replacement of other permanently wired
appliances I flxtures.
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a duplex'or condominium), including required service
electrical outlets.
Other
~,--_.-....._--_.",,--~_._,....~---_._-----------~-~----_..,'-'~'"----"_.._.""'"""~...,......_-,-.,...,._~-~.--,,.,~._------~---~~-~-,--..-~_....---""'--
The value or this work js $~j-:::08>, t9d
\ I hereby verif~/ this work win be perfurmed by an employee of this company and further verify
lhe recormection ! installation will be done in compliance with manufacturer and Electric code
reQUIrements.
L/~_26 r-<>-..2.
(Date)
(~,~_~~_~r" _\.~>'>~~?.~..~:~~~~:.~__-"-
(Print Name of Officer)
""
5/01