HomeMy WebLinkAbout0131528-HVAC (furnace)CITY OF OSHKOSH No 131528
OSHKOSH
ON THE WATER
Job Address 1231 MOUNT VERNON ST
HVAC PERMIT -APPLICATION AND RECORD
Contractor RYF HEATING & A/C INC
Fuel / Gas
System ~ New
/ Forced Air Rac
Electric Hot
Chimney Type Chimne A Chimn
Heat Loss As Approved Exi
BTU Rate As Per Plan Va
UselNature
of Work
Fees: Val
Issued By:
Owner AMANDA R PEPPLER Create Date 07/14/2008
Category 500 -Residential-Heating & Ventilatin Plan
Electric Solar Solid
Replace ~ ~ Other _ J
Steam A/C Vent i
_~
Suppl. Con. Burner
Direct Vent Not Aonlicable
B
Value
Value
SFR /REPLACE FURNACE, EIV SIGNED BY SECKAR ELECTRIC **check #14327
i
I
~ i
~i,uuu.uu Nlan Approval $0.00
Permit Voided
Parcel Id # 1506700000
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
Address PO BOX 450
Agent/Owner
WINNECONNE
WI 54986 -450 Telephone Number 920-582-4451
~,
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.
Permit Fee Paid $37.00
Date 07/14/2008
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
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.
If vna nre n cnnOtlrtnc/nr narticinatinQ i'n the Permit fee Account Svstem and have adequate funds, check here
** 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) mast 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.
JOB ADDRESS `O2 `3 C
OWNER Go r'c ~ _
.S~"
CHECK ®ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^
FUEL Gas ^Electric ^Soi id SYSTEM
^Oil ^Solar
pt !~-C. tL dl G
-Family ^Rental
DATE ~ `~5`' ~ 8
^Commercial
^New
^ Other
^ Industrial
Replace
TYPE ~
JI~Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ¢INo ^Y'~~es -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ' ^Chimney B ^Direct Vent Other
HEAT LOSS ^As Approved ^Existing Not Applicable
BTU RATE ^As Per Plan ^Variable ~OthDer Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE /I eA ~ac. C.. ~~~n rc,c-~
VALUE (Including labor and materials) $ ~ 1 ~ O o. p ~ (37 tTa
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) cS-C e..~ ~,
o~/o~
~~~~-, w~.~o
~~ ~
ilf CMrrY lwNws
p~ilt0
p~yyNb W1 i~•1130
0llle~ 106•t~~-'d
IKtt 0Y
Eli
I (we) CS~C~+ ~.~.
~~~~ ~
(Addha~)
17av0 ~seeri oontracbod t0
at the Lollowing address:
'ihe tutmre of the work
lteootmection or
Roconaertior. or
w~sr 1>wttcr.
Recoanectior: of
seal lighting :
Eatts~ce Cat
_,,,~, Recrnataectioa or
spp>laeuea / ~
__~__ Vew prauit for t
ir~diviatul sy
el~atriaal out
Other
Intetnllstfon Verificstton
L~~2~ ~ cn, /tv
(F,le;,trical Contractor lama)
~~~}
JJI~~On(~ ~~~f ..~--.~~~~o
electric installatioa work fo:
(:~Tanat of piny contracted to)
~3f /fit, 1/'>'~~~
(?-ddreas where work will be performed)
of: (Check One or Describe the Mature of ~~'ork)
=w circa t for replaae:awt Heating Plart aAdf'or .~'C Condenser.
e~+ circuit for;replaceaa~-t Electric Ovate: Hasler or power vented
Service 1"•ntrance Cable. Metoc Box, altezations to receptacles
:urea dtu to siding 1 soffit installation. Note, New Sorviu
c will req~sire a aaparato permit.
w circuit zor the replacement of other permanently wired
~. ; ,
addition of AJC to sn iadivldual dwsl!!ng srnir (house or tte
ms in A duplex or coAdaminium), inauding required servict
The value ott7+.is words
1 heroby verify this work will
t~+1C rOCOrf lectlQlZ I ic~allatti0n
rpq{~lrerlLOllN.
Company
I
O.. o J
performed by an employee of this cotnp~ty and fur*.her verify
Il be dotx incompliance with r~.uiufacturer aid Electric code
(Print Nanne of Offics~) {Date)
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