HomeMy WebLinkAbout0128155-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 795 GREENFIELD TRL
CITY OF OSHKOSH
No
128155
HVAC PERMIT -APPLICATION AND RECORD
Owner WILLIAM R1JEAN HOLMSETH
Create Date 12/13/2007
Contractor VANS HEATING & AlC INC
Fuel ~ Gas UOil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type KJ Chimney A o Chimney B
Heat Loss KJ As Approved () Existing
BTU Rate o As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U SuppL
. Direct Vent
U Solar U Solid
D Other
U AlC U Vent
U Con. Burner
() Not Applicable
. Not Applicable
. Other
Value
Value
Use/Nature SFR / Replace furnace. EIV provided by CSI Electric.
of Work
Fees: Valuation
$3,600.00
~
Plan Approval
$0.00
Permit Fee Paid
$64.00
Issued By:
Date 12/13/2007
D Permit Voided I
Parcelld # 0613992000
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 525 BUTLER ST
DEPERE
WI 54115 - 5426 Telephone Number 920-336-2816
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 of Inspection Services
P.O. Box 1130
Oshkosh, WI 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 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
J au are a contractor artici atin in the Permit ee Account S stem and have ade
if vou want this vrocessed through vour account n
check here
JOBADDRESS 71SG~.btlDd
OWNERWl!i/~_~
CONTRACTOR~:::> N~r\3
CHECK 0 ALL APPLICABLE
~CATEGORY
~gle Family o Duplex
DATE~
~.j'
i
~
DEe 1 3 2007
DEPARTMENT OF
COMMUr~ITY DEVELOP~fJENT
INSPECTION SERVICES DTVTSION
OMulti-Family
DRental
DCommercial
DIndustri~ll
FUEL ~s
DOil
DElectric DSolid
o Solar
SYSTEM
DNew
DOther
~place
TYPE
.~rced Air DRadiant DSteam DAlC DVent DElectric DHot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CIDMNEY TYPE DChimney A DChimney B ~ect Vent DOther
HEAT LOSS DAs Approved DExisting DNot Applicable
BTU RATE DAs Per Plan o Variable DOther Value
DESCRIPTION OF ALL WORK BEING DONE Q 2. plaQJ ~.w \"O.(LQ
ELECTRICAL CONTRACTOR
VALUE (Including labor and all materials including light fixtures) $3l.ctrr::s:J
OR ~Iectric Installation Verification form attached(If Replacement)
Electrical ins/allation of new /replacement equipment shall be done by licensed contractors
3/02
FROM CONCEPT SERV ICES .
FAX NO. 920-336-8697
Mar. 18 2003 03:01PM Pi
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OfH<g78
(llJ T~t Wh t2
City ~f~f,\.~b
Division Ofln.spectioll Strvi.cs
215 Cburch AVl'1luc
POBw.lljij
Osl1kosh WI 54903.1130
OfT>ee na.23&.50S0
Pa~ ~2o-2.36-5084
Electric Installation Verification
r (W e)
C'OY1 ((?j)f ~5(?fvl((?3
. (Electrical Contractor Name)
:J)e #Re J
I (CitY) ,
Inc, lGJI
flecl-r1 c
4035
(Address)
H l-JY .5'7
WI 54 If 5""
(State) (Zip Code)
,
have been contracted to perfonn electric installation work for VIt/"}.3 !J.tW.fI'"t (} t- (()::JL<v'l..3
(Name of party contracted to)
at th~ following address: B ~ bh. ~ JJ\\ \--1.~d \ ~
. (Address WhO: w~il bep~OnlWd) .
The nature of the work consists of: (Check One Or Describe the Nature of Work)
---:i.. Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
wa.ter heater.
Reconnection of the Service Entrance Cable) Meter Bo~ alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note; New Service
Entrance Cables will req~ a separate permit. .
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a duplex or condominium), inc~uding required service
ele_ctric.a1.Qut1ets.,:"_~,~__~__~___, . __ _ __..<.__,:i-;~~
Other
Dce 13 2007
The value of this work is $ )'00,00 .
nFPARTi'VlEtF OF
COfvlMUNITY DEVELOPi'1ENT
INSPEqrOf\J SERVICES DIVISION
-I hereby verify this work will be perfonned by an employee of this company and further verify
the reconnection I installation will be done in compliance with manufacturer and E~e.ctric code
requirements.
J)Av;. d JhRoJ
(Print Name of Officer)
illJ \ ct IDl
(Date)
(Signature of Company Officer) C