HomeMy WebLinkAbout0128092-HVAC (furnace; a/c)
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OSHKOSH
ON THE WATER
Job Address 675 N MAIN ST
CITY OF OSHKOSH
No
128092
HV AC PERMIT - APPLICATION AND RECORD
Owner
RALPH H BECKER ETAL
Create Date 12/07/2007
Category ~O~~_~l~~!l~~:Both _.__________
Plan
Contractor
MARTENS HEATING & COOLING
Fuel ff~~s__..-J U~___J D--EiE;clri~===:J U_~J.a!:~~=':~:]
System 0 New 0B~place _________.J
~ Forced Air U Radiant ::J U Steam_-~~_J ~~_:==~J
IT~_~~t':!.~ U Hot Water =:J u_Suj)er==_::J U~~lJTrieCJ
Chimney Type D~gJ1imney p:--~ Chimney B --===D=:Qi{e_~LYerlC=--===. Not~pTicable -.-J
Heat Loss (I_.As-APPrc)ved----"'::O Existing . Not Aep.U~~Ie~===J Value
BTU Rate QAs Per Plan O__'{ariabl~____~====_. 01..her=====-.=J Value
D~<l!i~C:~
Other
D'Z:~t -~-::.:
Use/Nature COMM (UPPER UNIT - APARTMENT) / REPLACE-Fm~-NACEAN15ADDCENfRATAiR:-EIV SIG-NEO-S'r5 KALELECfRIC-**debfacCt
of Work I
I
I
I
I
L__.______________________________ ._____.
Fees: Valuation $8,379.00
Issued By: ~~---
Plan Approval $0.00
Permit Fee Paid
$136.00
,,________'_... m_
Date 12/07/2007
D..P~.rnit V.?.iged I
Parcelld # 0700850000
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 514
OMRO WI 54963 - 514 Telephone Number
920-685-0111
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
~
OfHKOfH
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
1 au are a contractor artici atin in the Permit ee Account S stem and have ade uate unds check here
au want this rocessed throu h our account'
** Advisory - For applicable projects, all 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~ (o/;)C07
JOB ADDRESS (015 N. mo \ \\ st (. up per' ApfJ
OWNER 12-o.\~h beCKer .\
CONTRACTOR1I\Qr-te03 Heo.+;~ 1 Ctldi~
CHECK Ii:1 ALL APPLICABLE
USE CATEGORY
~ingle Familvo DDuplex DMulti-Family
.~~
C,oh\VX\{l( C; 0--\ Db 1-\-0 Il'\
FUEL mJas DE1ectric DSolid
DOH DSolar
DRental o Commercial Dlndustrial
SYSTEM ~ew CaReplace
o Other
TYPE
))Forced Air o Radiant
oAd
DSteam ~AIC DVent DElectric
DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE DChimney A DChimney B DDirect Vent o Other
HEAT LOSS DAs Approved o Existing DNot Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE~IQce ~l(naCe (1,(\0\ oGlc\
ce~\ Q\l \(\-\t\Q. Urpevur\i+ (~~r~6\+)
VALUE (Including labor and materials) $ t:> I ~ iC} .00
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) D. koJ Ela-/-rl/
07/07
~EC-7-2007 l0:l5A FROM:
:;: liee. I. Lvvr O:!f-/MI
:::
InspeCtion services
TO: 2365084 P.l
I~O. O:J'to r. I
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City ofOlll1ko~
Divisioo aflllllpOGdon licrriocl
2 U Ch~tllh A \0011116
!'tHin. 1130
O.lJ1m,h WI "49D3.1130
Offi~ !}~n.Z~6.50JD
Fal 920.236-5084
Electric Installation Verification
I (We) \D. KA L b- 'e.C.\-~\ c.. l. l. C .
(Electrical Contractor Name or Homeowner's Name)
Liycl3 Rv.s,,"\or~ Av<.
(Address)
~ \Nwo
(City)
I JJ 1:.
(State)
5yQ, ~
(lip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
to 75 .AJ. ;1;t~~ \t\ ~jv~ c{
(Address where work will be performed)
The nature of the work consists of: (Check One or Dcscribe the Nature of Work)
X Reconnection or new circuit for replacement Heating Plant andlor AfC Condenser.
Reconnection or new circuit for replacement 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 I soffit installation. Note: New Service
Entrance Cables will requirc a separate permit.
Reconneclion or new circuit for the replacement of other permanently wired
appliances I fixtures.
New circuit for the addition orAle to an individual dwelling unit) including
required service electrical outlets. Nole: Homeowners can only do their own
electric on a single family owner ocr:~tpied home. Work on a condominium,
duplex, rental, or multi-use building WQuld require a licensed Electrical
Contractor.
Other
The vah.1c of this work is $ Q? I)~ PO
I hereby verify this work will be pt:rformed in compliance with the License requirements of
Section 11.22 of the Oshkosh Municipal code and further verify the reconnection I installation
will be done in compliance with manufactuter and Electric code requirements.
~~~~
(SignaIU~ of Company Offlcc:ror Homeowner)
_tA n I ~ \ L. )::' t\ l {It 5
(PrintN.:une)
L '"J.... ~ 7,.. 0 7
(OlilC)
07/07