HomeMy WebLinkAbout0128168-HVAC (a/c)
o
OSHKOSH
ON THE WATER
Job Address 1924 HAZEL ST
CITY OF OSHKOSH
No
128168
HVAC PERMIT - APPLICATION AND RECORD
Owner MILTON B GOLDINGER
Create Date 12/14/2007
Contractor DRUCKS PLUMBING & HEATING CO IN(
Fuel I~ Gas I J Oil
System RJ New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss D As Approved () Existing
BTU Rate D As Per Plan () Variable
Category 501 - Residential-Air Conditioning
Plan
I I Solar U Solid
o Other
l!:J AlC U Vent
I I Con. Burner
. Not Applicable
l!:J Electric
o Replace
U Steam
U Suppl.
() Direct Vent
. Not Applicable
. Other
Value
Value
Use/Nature ~FR /Install Space-Park High Velocity AlC System. EIV provided by Triumph Electric.
of Work
Fees: Valuation $9,000.00
Issued By: ~
Plan Approval
$0.00
Permit Fee Paid
$145.00
Date 12/14/2007
o Permit Voided I
Parcelld # 1514816400
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
POBOX 355
MENASHA
WI 54952 - 355 Telephone Number 920-426-2654
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
DivisiR)) of Inspection Services
"P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THF WATFR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplet.~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 f~e, which ever is greater. .
OR
Ifvou area contractor participatinf! in the Permit fee Account Svstem and have adequate funds, check here
if vou want. this processed 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.
DATE 12.. ~(C,- o?
JOB ADDRESS '1~ z-y
!fA 2/::7- 5;7
OWNER i\!lfL1O;0 Goc-bIN(...,t::!L..
CONTRACTOR [)ttu..u<s ~cm.r -.:::3 ~ /-/(1'471"-'<::'
CHECK ~ ALL APPLICABLE
USE CATEGORY
IlgSingle Family DDuplex DMulti-Family
DRental
o Commercial
o Industrial
FUEL
DGas
DOi!
IiDElectric QSolid
DSolar
SYSTEM
IRJN ew
o Other
DReplace
TYPE
DForced Air DRadiant DSteam ~/C 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
HEAT LOSS
BTU RATE
DChimney A'
DAs Approved
DAs Per Plan
DChimney B
DExisting
DVariable
DDirect Vent o Other
DNot Applicable
DOther Value
DESCRIPTION I SCOPE OF ALL WORK BEING DONE
/'0SMu...... ~p~ -PAeCC- f-/((:;.r-I V65LOC-/'Y Ale. ~yr~ ~"'! 1.._-
DEPJ\RTI'V1ENT OF
coiVliYlU I'J 1. I y UtVtLUI-'I'il!::NT
IPJSPECTlm'j S::RVICES C'~\./ISION
VALUE (Including labor and materials) $ 'OCO:=:!.
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) (i4v........ /4./
I!L~(C-
07/07
i
J
t
I
,.
,
I
Ii
04/16/07 08:13 PA! 7220651
~
0JH<dtH '
011 'lWll'Il\tE'
DRUCKS
4"''''' HERITAGE ELEeTRI
Igj OZ
Clyor~h
DMlfcmor~~fi.
215 C1MIRhA""lIII~ .
FOh njO .
OsllIcNII WI $Il~.1 fIG
~~""$C50
t'I<< ~:JUI2M
Electric.Instillation Verificatiob
l' (\I).. Y'I\ (2 h <i ('C.d r .: '(. ~ 1\ C.
(Btectrica.t Co.t.lttacto:t Name). '
id 6 W .lAJ~~. \ Ctlf\c9 Ave.. Q ~f.' {"'(.. 4--0 N I WI
(Adcttess) (City) (State) (Zip COde) sf{ q IV
have been contracted to perfonn'electrieinlrtaUatiotJ. "WOTk for ~Q,!! ~ fL. <-<..c> r rrf'a,
(Name of party co.ntra<:ted to)
19d'l ;-ft;z..cf Sri
(Addrf:S$ where work will be perfunned)
(1) (W~)
at the foUowing address:
~
The nature offhe work consists of: (Ch~ek One or Desorlbe the Nature ofWotk)
.
Reconneetion or:ant circuit for n:place:rnem: Beating Plaut and/or Ale Condenser.
Rcconnection or new circuit fQr x.placement Electric Water Heater.
R.cconnection of the Service Entran~ Cable, Meter Box, alterations to receptacles and
lighting .fixtures due to siding I soffit itJ$tIllatiOD.. Note.: New Service Entum(:1l
Cables wUl require a separate pcm.ti.t.
Rcconnection or new ~t.fOr other per.rnanently wired applisncC$/ nxtures.
Other
lPT
The value of this worle is $_ .'
~.
$30u.O<.)
! hereby verifY this work will be performed by an employee of this company and :further verifY the
:\"eQ<)mect'ion I installation 'Will be done in c:omplimice with ma:t1ufacturcr and Electric code
reqtUrl1ntlents.
~f~~)
M a l'~llc-bffl it "-
(Print N. e of Officer)
1~f1
- ?m
~
~
, ,
DEe 14 2007
DI:PARTI'vlEI'H
COi\1MUNITY DEVELOPi'1ENT
INSPECTION [)T\/ISION