HomeMy WebLinkAbout0128093-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 540 WAUGOO AVE
CITY OF OSHKOSH
HV AC PERMIT - APPLICATION AND RECORD
No
128093
Owner DEAN J/MARA SMITH
Create Date 12/07/2007
Contractor A-1 HEATING & NC INC
Fuel L~~
System D New
U Forced Air
U Electric
Chimney Type ITChimney A
Heat Loss U As Approved
BTU Rate U As Per Plan
Category ~OO::J3eside':1ti?!:Heatinfl~Yentilat!i:tg__ Plan ________________
Wle~!i:i~=] D-Sol?!_~_=:-:-~J D:~~i~=:::]
o Replace OQher____J
U Radiant ~~J U NC UVent ___J
~ Hot Water ~ LJ Suppl. J U Con. !,!urn~
o Chimney B_~_c~E~.r:!L______.~AJ>plicable =:J
() Existing___tt Not ~eElic~I:J~____] Value ___________
( )~~~!able__=--===.__Oth!?r:===-====] Value
UOil
-,
.....!
Use/Nature PUPLEX (one boiler seniices both units) 1 REPLACEBOILEI{ EIVSjGNEO-SVSELL--ETE-CTRIC-"cheCk#892S-
of Work:
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I
I
I
I
L
,
_________."...._.1
Fees: Valuation ______-.!4,678.00
Issued By: ~
Plan Approval
$0.00
Permit Fee Paid _________ $80.50
Date 12/07/2007
0_ Permit V_o.ided I
Parcelld # 0202370000
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 W8078 HILLCREST CT
HORTONVILLE
WI 54944 - 0
Telephone Number 920-779-8838
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
PO. Box 1130 .
Oshkosh, \VI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
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 54903L 1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, 'fhich ever is greater.
OR i
!' ou are a contractdr artiei alin in the Permit ee Account S stem and have ade uate runds~ check here
ifJ.2u wanuhls orocdssed throuzh \lour account n
i .
JOB ADDRESS '- r::;L/O
OWNER :,.7)"f.:,ql\i
CONTRACTOR
l(v It Lc 6-6C'J A-'(l~.,
~ \'/tLfTI-{
DATE 1<<- 2- () 7
A.,j Heating & Ale
m?0'7b' l1iilo eM Ct.
flor'ttmvilk W!54944
q'LO"11 Cf- g f? 3g
CHECK [tj ALL APPLICABLE
USE CATEGORY
IT1Si~gle Family dDuplex
OMulti-Family
ORental
OCommercial
o Industri al
FUEL
~s
OOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
CflReplace
TYPE i
OForced Air ORadiant bSteam DAlC DVent DElectric ~t Water DSuppl.DCon. Burner
!
IS CHIMNEY BEING LINED [91\fo DYes - LINER SIZE
Note All chinmeys shall b~ sized per lhe BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEA T LOSS
BTU RATE
DChimney A
:DAs Approved
pAs Per Plan
DChimney B
DExisting
DVariable
DDirect Vent m.eJther
DNot Applicable
DOther Value P / Lie
J ?J i /.) 'I,
t) 1/ I lJO"Q !J U..I.J: f':>,:y e t
/
I
DESCRIPTION OF ALL WORK BEING DONE r-e_([) leu:. P "'('Pi.<-+-
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\1 ..... ~
,; fie,.
VALUE (Including labor andall materials including light fixtures) $ \..ff..t.7 ff ._
$F() 00
ELECTRICAL CONTRACTOR .t 2: If
OR M1ectric Installation Verification form attached(lfReplncement)
Electrical insrallation of new/replacement equipment shall be done by licensed con/melO/".\.
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Electric Installation Verification
I (WCl---,-__Il.~_L~,..._.1?L~c;.1r; <...
. (Electrical Contractor Name)
"'_'. {Joy; ,...,..6 QL~..!!2...._Jl~"tnh~
(Addres~) (City}
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S"y~S ~
(Sta1Cp (Zip Code)
/}.-I fI('.~,(fr~J ff /t!L-,
(Name of PnfY contracted to)
1..../1
l1;J\'C \)1.:\:1) wnlracte<\ to pcrfonn c\cchic installation work for
be:;>>-.J ~+t'-. 9;;l{) - 3tJ:f3- /1&.,3
~l the following address: ~()___~~J'/ GL6-tJO X-v€-... t'St..., k.,( ( ,
(Address where work will be perronn~d)
i
I
'I11c nature of lhl work consisls of: (Check One or Describe the Nature of rOTk)
....~ Rcqonn~clion or new circuit for r~lncement H~nlif1&..PIa.n\ an~/or Ale Corldenser.
'__._ Rec;onnection or new clrc\\i\ {'or r~rlacement Etectric Water H~aler or power vented
'water heater.
Re~onncctjon ol:thc Service Entrance Cable, Meter Box, alten;tions to receptaclos
'uno Hghtlng fixtures due to ~iding I soffi1 inslallation. Not~: 'New Service
. bntrance Cables wi!! require a separate permit. .
~cc{)nncctiof\ or new circuit for the replacement of other permanently wired
i appliances! fixturt:s.
~ef.v e ire\! i t for the nc.ldit ion 0 r Ale to an indlvidullI dwelli"g I.mil (house orthe
: il\(ii vidual systems in i1 duplex or condominium), includln~ re<juired servict:
, electrical 0tlllet!i,
O\her
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The \~\liC ~)f \hiis work is $
---'--
--'
\ hen:\1y "C'rif.Yllhi~ work will' he performed by litl employee ofthis compal:ly and furthcl verify
the Il'C(lfll)\.'CI19" ! installation will be done in compliance with manufacturer Md gleclric code
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(Prinl Name of Officer)
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