HomeMy WebLinkAbout0131603-HVAC (furnace)CITY OF OSHKOSH No 131603
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1715 MICHIGAN ST Owner DAWN R WAGNER Create Date 07/17/2008
Contractor WESLEY HEATING & COOLING INC Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System ^ New ~ Q Replace ~ ^ Other
/ Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimne B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value 70,000
Use/Nature
of Work
°cneck ~s4yys
Fees: Valuation
Issued By:
Plan Approval $0.00
Permit Fee Paid $65.50
Date 07/17/2008
^ Permit Voided
Parcelld # 1404510000
In the performance of this work, I agree to pertorm all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you pertorm the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Address 3220 BASLER LN
Agent/Owner
OSHKOSH WI 54901 -0
Telephone Number 920-235-6951
To schedule inspections please call the Inspection Request line at 236.5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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City of Oshkosh ~U~ 1 7 20~$
Division of Inspection Services
P.O. Box t 130 DEPkRTMENT OF
Oshkosh, WI 54903-1130 COMMUNITY DEVELOPMENT
Phone (920) 236-5050 INSPECTION SERVICES DIVISION ~/ ~f
Fax (920)236-5084 ~ HKO I I
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HVAC PERMIT APPLICATION
All information rafter 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
If you are a contractor participating in the Permit fee Account System and have adequate funds check here
if you 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) 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.
DATE ~ ~ ~ - ~~
JOB ADDRESS ~'~ 5 ~ ~ '~~n~ ~-
a ..
CONTRACTOR ~ -~ ~~
CHECK C~1 ALL APPLICABLE
USE CATEGORY
,Single Family ^Duplex ^Multi-Family ^Rental ^Commercial
FUEL .Gas ^Electric ^Solid SYSTEM ^New
^Oil ^Solar ^Other
^Industrial
<~Replace
TYPE
forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ^No Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B L~IDirect Vent ^Other
HEAT LOSS ^As ApprovedExisting ^Not Applicable
BTU RATE ^As Per Pan ^Variable C~.,2ther Value ~~~ C ~ _i _,
DESCRIPTION /SCOPE OF ALL WORK BEING DONE -
~- _ Sul r "'C~.S ~->
VALUE (Including labor and materials) $ d~~~ 1~~~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ~~ i~~~1 ~1~~z ~
o~/n
_-~~21~8 20:3'~ FRAM WESLEY f-~aTIN~
aiq:~formosh
pih~ioa of Ln~eaim SeroielX
7i5 CluieeM A.aiao
PD Sex 1 f 30
oh Vtl S4'~d-L 134
~~}~ ~ 4ttl-llF-5030
Q,. ~.~OQiL~-~-' 9T0.236•SOl~1
0920? 2".s5-b951 70:2357725 P.2
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~iectric Instaiiatian ~e>r~tficatian
(.Electrical Contractor Name or 1-(orneowner's Name)
(Address} (City) (State) (Zip Code)
accept the responsibility to perfocrn the electric vkork as stated below, at the following address:
(Address where work bail be pexfonned) ,
The nature of the work consists of (Check One or Describe the Nature of Work)
~ti _ l~econt~ctivn or-new circuit for rep>~acemEnt Heating Flant and/or AIC Condenser.
__ reconnection or new circuit for rep~aoement Electric Water Heater or power vented
water heater. '
~teconncction of the Service Entrance Cable, Meter Bnx, alttions to receptacles
and lighting f~t~ares duo to siding / soffit instaltation. Note; New Service
Entrance Cables will require a separate permit,
Reconnection or new circuit for the replacement of other permanent}y wired
appliances /fixtures.
__ _ New circuit F'or the addition of A!C to nn individual dwellt»gi u»ff, including
required sexvice electrical out{eta. Note_ Homeowners can only dp their own
electric on a single family owner t-CCUpiBGi home. 6York on a canclominium,
duplex, rental, or molt!-use building tivo:<!d require a licensed Electrical
Contractor,
Other
T'he value of this work is ~
I here~;y verify this work will be ;performed in compliance wh the License requirement, of
Section I I-22 of the Oshkosh Municipal code and. further verify the reconnection 1 insta'.iation
~Jili be done in corr~pliance with manufacturer and Irlectrita.code requirements,
(5ip~a rc ofC mpxnp~ officer or Nomcawrtcr) (print Name) ~~ ~(}~~~)
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