HomeMy WebLinkAbout0131886-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address 419 W 19TH AVE
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
i
Owner. JUNE ACKERMAN
No 131886
Create Date 07/28/2008
Contractor MARK WEBER HEATING & COOLING IN Category 500 -Residential-Heating & Ventilatin~_ _ Plan
Fuel (/ Gas Oil ! Electric Solar i Solid
^ ~ ~-- --
System ^ New ~ ^/ 'Replace
~ ~ ^ Other
/ Forced Air Radiant Steam A/C Vent
Electric Hot Water ~~ Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existin Not Applicable Value
BTU Rate As Per Plan Variable ! Other Value
UselNature ~SFR /REPLACE EXISTING FURNACE, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES (Greg Davis) "debt acct
of Work
Fees: Valuation $2,000.00 Plan Approval
Issued By:
^ Permit Voided
Date 07/28/2008
Parcelld # 1407090000
In the pertormance 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
Agent/Owner
Date
Address 1075 ISLAND ESTATE CT OSHKOSH', WI 54901 -1341 Telephone Number 235-1523
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 $40.00
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.
O1HK-O~H_
ON THE WATER
• 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 fcc, which ever is greater. '~
OR ~'
** 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 withoat an EIV when such is required, will not be
processed for Permit Issuance and will be retarned for completion. l
DATE ~ ~ ~7 / O~
JOB ADDRESS ~l^ ~~ l
OWNER ~ I ! ~~ 1~ ~ / ~ ~ l
CONTRACTOR !~?/~2~ - l-~
CHECK H ALL APPLICABLE
USE CATEGORY
.Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ~ ^Electric ^Solid ~ SYSTEM ^New ~eplace
^Oil ^Solar ~; ^Other
I .
TYPE
forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED J~No ^Yes -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 DAs Per Plan ^Variable ^OQth~er~Value
DESCRIPTION /SCOPE QF ALL WORK BEING DONE T`s~Er 1 `~
VALUE (Including labor and materials) _~/X~~ . ~ J
ELECTRICAL CO1~iTRACTOR (for projects not requiring an EIV Form)
o~~o~
City ofOsluosh
Division of Inspection Setroice;
2!5 Church Avenue
PO 83x 1 i 34
J Oshkosh 1:'1 54903-1 i30
o OiC~ce 920.23b-i0S0
ON iN vthiER Fax 920-23G-50fi4
Elec~r~c Installation Verif~catian
-~ I ~- ~
(Electrical Contractor Name)
~~~•. h_ 1 _4 t{^aJ... 3.. _.{ [-_ ~ ~r'. i~ ~;:-. -' 4•a, 4.,,5 _! ~ _~ ~~ l / ('
(Address) 'i (City) (State) (Zip Code)
have been contracted to perfornl electric installation work for ~( ~~"~~., I~Z .,
{Name of parry contracted to)
at the following address:
{Address where work will be performed)
i
The nature of the work consists of: {Check One or Describe the Nature of Work)
Reconnection or new circuif for replacement Heating Plant andtor A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection. of the Service Entrance Cable, Meter Box, alterations to receptacles
and Iighting textures due to siding l soffit installation. Note: New Service
Entrance Cables ~vili require a separate pennit.~`
Reconnection or new circuit for the replacement of other permanently wired
appliances /textures.
New circuit for the addition of A,JC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets. ',
Other
The value of this wark is ~~-~~~(.~.
I hereby verify this work will be perfa~-rned Ilby an employee of this company and further verify
the reconnection /installation will be done in compliance with manufacturer and Electric code
requirements. ~,
~`
. i t.,
(Signature df Company Officer)
~~ (Print Name of Officer}
~ zz
(Date)
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