HomeMy WebLinkAbout2008-HVAC (furnace)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1922 PLYMOUTH ST
Contractor WESLEY HEATING & COOLING INC
Fuel / Gas Oil
System ~ New
Chimney Type
Heat Loss
BTU Rate
Use/Nature ~
of Work
/ Forced Air Radiant
Electric Hot Water
Chimney A Chimney B
DOROTHY HAZEN
No 130378
Create Date 06/06/2008
gory 500 -Residential-Heating & Ventilating Plan
Electric Solar Solid
Replace ~ ~ Other
Steam A/C Vent
Suppl. Con. Bumer
Direct Vent Not Applicable
Not AI
Other
Fees: Valuation
Issued By: _
Plan Approval
$0.00
Voided
In the performance of this work, I agree to perform all work purse
While the City of Oshkosh has no authority to enforce easement
described in this permit appligtion within an easement, the City
holder(s) and to secure any necessary approvals before starting
Signature
Parcel Id # 1216610000
to rules governing the described construction.
rictions of which it is not a party, if you perform the work
ugly urges the permit applicant to contact the easement
i activity.
Date
Address 3220 BASLER LN
OSHKOS~i WI 54901 -0 Telephone Number 920-235-6951
To schedule inspections please call the Inspection RequE
Inspection (i.e. Footing, Service, Final, etc.), Access into
Number. Unless specified otherwise, we will assume the
continue if the inspection is not performed within two buy
,t line at 236-5128 noting the Address, Permit Number, Type of
wilding if Secure {how do we gain entry), your Name and Phone
project is ready at the time the request is received. Work may
Hess days from the time the project is ready.
Value
Value 50,000
Permit Fee Paid $47.50
- Date 06/06/2008
~~ ~~
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
RECEIVE
JUN 6 200
HVAC PERMIT APPLICATI(~~aRTMENT of
All information after bold categories mus DEVELOPMENT
Incomplete abplications will not b~~ ~N SERVICES DIVISION
• 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 ithout permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
** Advisory -For applicable projects, an Ele
Contractor or Homeowner (for installations
with the permit application. Applications si
processed for Permit Issuance and will be rep
JOB AD
Installation Verification (EIV) form, signed by the Electrical
'd to be performed by the homeowner) must be submitted
~d without an EIV when such is required, will not be
for completion.
DATE~'~~ ~~,c~
CHECK 0 ALL APPLICABLE
USE CATEGORY
1,~Single Family ^Duplex ^Multi-F
FUEL l~Gas ^Electric ^Solid
^Oil ^Solar
TYPE
Forced Air ^Radiant ^Steam ^A/C
IS CHIMNEY BEING LINED ~No ^Yes - L
Note: All chimneys shall be sized per the BTU's being
CHIMNEY TYPE ^Chimney A ^Ch
HEAT LOSS ^As Approved ~Ex
BTU RATE ^As Per Plan ^Va
DESCRIPTION /SCOPE OF ALL WORK BE
^Rental ^Commercial ^Industrial
SYSTEM ^New [Replace
^Other
Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
fER SIZE & MANUFACTURER
iinney B ~IDirect Vent ^Other
i ting ^Not Applicable
r'able )Other Value ;-~L~~^~
.I G DONE \-la ~ r~ ~ c t .~ ~ ~k'N~
VALUE (Including labor and materials)
ELECTRICAL CONTRACTOR (for projects not re airing an EIV Form) ~ L~l
'~,
o~ro~
05/27/2008 07:09 9202737965 K-K tLtLIh~1L LLI; rt~ut k~l! t71
~-r-+r -cam-cps Cl : ~ r hic't]'1:4J~EY F~ATING t9~01 235-6951 T0.1926~,737965 P. 2
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execs 9I0-=3s-sesO
Ftie l2i~7d,SIMo
I {We)
{Address}
~iCC~i'1C Itll~lkS~~10
I {Electrical Conti ictor 1~Tarm~
accept the c~nsibiility to perform the
{Aaaress ~
The nature of the work consists of (Ghee
Recannectiandr new circuit
Reconnection~or new circuit
avatar heater.
1iect~anectian of the Service
and lighting fixtures due
~trartce Cables v~nll regi
____,~ Reconnection Qr new circuit
appliances 1 £uctures.
New circuit f.~r the addition ~
required service electrica
electric orr a single famll
duple, rental, or multiu
Contractor.
Other
'i'he value of skis work is
Y81 I~1CS>bOfl
ar Ham er's Name)
tGity) (State) (Zip Code)
work as stated belaw~ at tl+e fallowleg address:
wlEl Ex performed)
One ar ~sctibe the Nntur+s af; fork)
x replacement Heating Plant andlor A/C Capdenscr.
~r replacemerrt Electric Water Heattr ter po~er vented
~ntran~ce Cable, Meter Eox, alterations to receptacles
~ siding / soffit installation. Mote: New Service
;rc g she permit
~r the replacement of other permanently wired
FAfC to an individual dwelling unit, inclutEir~g
outlets. Note: ffa~reeowners crux only do their own
owner occ~ied Name. fork on rr cvr~domirriTrnt,
e 8utlding ~rbuld require a lr`oensed Electrical
I herby verify this work will be performed in compliance with; tits License requirements of
Section 11-22 of ttte Os~hkoah Municipal coda sz~d further verify the reconnection /insulation
will be done in compliancy witfi manufaurec and Electric code requirements.
(S orCoalpa:~r Officer m Ftameovmer) (T+nnt Name)
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