HomeMy WebLinkAbout0131596-HVAC (furnace)/~"~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1924 DOEMEL ST ' Owner DIANE MUGGENTHALER
No 131596
Create Date 07/17/2008
Contractor THOMPSON HEATING AND COOLING S Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil ~ Electric Solar Solid
System ^ New ~ ^/ Replace ~ ^ Other ~
/ Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimne A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existin Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature
of Work
IGNED BY T RUCK ELECTRIC
Fees: Valuation $2,400.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
Date 07/17/2008
^ Permit Voided ~ Parcel Id # 1514811000
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 901 OTTER AVE
Agent/Owner
OSHKOSH
WI 54901 -5444 Telephone Number 920-426-3095
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.
$46.00
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.
DATE ~~° ~~
• 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
~you are a contractor partic~ating in the Permit fee Account System and have adequate funds, check here
iJyou want this processed through your 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.
JOB ADDRESS / ~ 7" JOC~l1~~-
OWNER ,~-!C''~~'~i~~/~ KC~E~
CONTRACTOR //~I~L1 ~.S~N
CHECK ®ALL APPLICABLE
USE CATEGORY
L~Single Family ^Duplex ^Multi-Family ^Rental
FUEL Bias OElectric ^Solid ' SYSTEM
^Oil OSolar
TYPE
~orced Air ^Radiant ^Steam ^A/C ^Vent
IS CHIMNEY BEING LINED ~No ^Yes -LINER SI:
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A DChimney B
HEAT LOSS ^As Approved ^Existing
BTU RATE ^As Per Plan ^Variable
^Commercial
^New
^Other
01HK01H
ON THE WATFR
^Industrial
p~Replace
^Electric ^Hot Water ^Suppl. ^Con. Burner
~E & MANUFACTURER
~irect Vent ^Other
^Not Applicable
^Other Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE ( ~ f'y,~~ =r-~~
VALUE (Including labor and materials) $ ~ 7"T/ y . CN
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~~o~
City of Oshkosh
Division of Inspection Services
21 ~ Church Avenue
PO Box I ! 30
~~~~ ~~
i Oslil:osh WI 54903-1 1 30 ',
Office 920-236-5050
orv THE wnT=F Fax 930-2365084
Electric Installation
~ !,
I (We) v"~- ~
(Address)
Verification
(Electrical Contractor Name)
~°Io z
', (City) (State) (Zip Code 3
have been contracted to perform electric installation work for
~~- i~
', (Name of party contracted ta)
at the following address:
(Address where work will be performed)
The. nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heatin Plant and/o
Reconnection or new circuit for replacement Electric Water Heater err powedr vlented
water heater.
Reconnection of the: Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New- circuit .for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condor-,;,,i„n~) i„o,,,~di„ Q ,.~,,,i;rv ~~° ~~
electrical outlets. ~ ' `~" sue. ° "~~
Other ~I
~'he vaiae of this work is $ ~~. /~
I hereby verify this work will be performed'by an employee of this company and further verify
the recoruiection /installation will be done in compliance with manufacturer and Electric code
requirements.
i
(S gna ure of Company Off cer) ;
c ~~
(Print Name of Officer) (l~ate~ ~~