HomeMy WebLinkAbout0131901-HVAC (furnace) CITY OF OSHKOSH No 131901
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 407 W 16TH AVE Owner ROBERT W BAHR Create Date 07/29/2008
Contractor BLACK-HAAK HEATING Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System ^ New ~ ~ Replace ~ ^ Other I
/ Forced Air Radiant ', Steam
~ A/C ~~~
_ . _ Vent
Q
Electnc
Hot Water
-
i
Suppl. ~ _ _
_.
[Con. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable J
Heat Loss As Approved Existing Not Applicable ~ Value
-------
BTU Rate As Per Plan Variable Other Value
Use/Nature
of Work
Fees
>FR /REPLACE EXISTING FURNACE & LINE THE CHIMNEY, EIV SIGNED BY KRUEGER ELECTRIC *"check #17813
I
i~
Plan Approval ' $0.00 Permit Fee Paid $85.00
Issued By:
^ Permit Voided
Date 07/29/2008
Parcel Id # 0907820000
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
Agent/Owner
Address PO BOX 7075 APPLETON WI 54912 - 7075 Telephone Number 920-757-9990
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.
City of Oelskoeh ~ e - ~ ti:'
~tvtston of 7~pec2ion ScTVic~s r ;F, ~, ;
P.O. Box 1130 - ~
Oshkosh, WI 54903-1130 '
Phone (920) 236-5050 JUL 2 9 2008
' 01HKO.IH
Fax (920)236-5084 ., ,
t.,~"fi'~'~t,~, ~ ~' U~ • "; ON THE WATER
~.~Y~i~~ ~~ HV~r ~Nt~T"~~i~L(C14TiON
-y 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 VJI 54903-1128. Cornmencing work without permit(s) will result in fees being doubled or $100.00 peas the
normal permit fee, which ever i~ greater.
OR i ~ .. ~ ~- -~---,. L---
DATE ~ I ~~ ~~~
JOB
CONTRA
CHECK ~ ALL APPLICABLE
U E CATEGORY
4~Single Family Duplex Multi-Family ORental ^Commercial Industrial
SYSTEM <]New ..,Replace
FUEL ]Gas !]Electric ^Solid
^Oil ^Solar ~ DOther
E I
orced Air ORadiant ^Steam ^A/C (]Vent ^Electric Hot Water ^Suppl. ^Con. Burner
1
IS CHIMNEY BEING LINED 1~No Yes -LINER SIZE ~~~' & MANiJFACTiJRER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
Chimney A
As Approved;
DAs Per Plan
Chimney B
Existing
Variable
DESCRIPTION OF ALL WORK BEING
VALUE (Including labor and all materials
ELECTRICAL CONTRACTOR _L1L
0 For applicable projects, an Electric
attached. If not attached or not applicab
Direct Vent
Not Applicable
^Other Value _
light features) $ V ~~'
,llation Verification form, signed by the Electrical Contractor, must be
a separate Electrical Permit is required.
^Other
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I`~'a~
ition Verif c~tiia~n
t..
(E~e'ctrical Contractor Name)
~ ~ .~~~ ~a
(.4ddres) (City) (State) (Zip Code)
have been contracted to p~cfonn rlcctria inscallati I work for ~aa~. ~ °
(Name aF P'irh' contraotod
at the; following addreys:
(Addxess'where work wi11 be performed)
The natw°c o.f the work consists of : {Check One or Describe the Nature of Work)
I
Rrconncction ur new cin;uit for ncplacerncnt Heating Plant and~or u11C Condenser,
_ Recanncction or new aicxtxit far' rCplacGmerit Electric Watlaz' water.
_._ Recaru2rctican of the Service Entrance Cable, Meter Bax, alterations to ree:eptaeles and
lighting fixtures due ko sidlri~! soffit instal.l.xtion, Note; New Service k:ntrancc
Cahlc>a will require a separate permit.
_._.__ Reconnection or new circuit for, otharpermanently.wired srppliances ! f"txtures.
Qther I
~l~e vnlUa c1~-thiS Work 15 $_ '.
Thereby verify this work wi11 be performed by an ~mployec 4f this catnpany and further ~er1Fy the
reconnection / uutallatian w211 be done in conipliancc with manufacturer and E1e~tri~ code
rrquiremcnts, j
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(5ipnaturc o Com y Officer)
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