HomeMy WebLinkAbout0131992-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address 20 W 14TH AVE
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Contractor MARK WEBER HEATING & COOLING IN
Fuel
System
Chimney Type
Heat Loss
BTU Rate
/ Gas Oil
New ~
Forced Air / Radiant
Electric Hot Water
Chimney A Chimney B
Value
No 131992
"debt acct
UselNature FR /REPLACE EXISTING BOILER, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES L
of Work
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III
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Fees: Valuation $2,500.00 Plan Approval ! $0.00 Permit Fee Paid
Issued By: ~~ml~. ~I
$47.50
Date 08/04/2008
Permit Voided
Parcel Id # 0304210000
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 Date
Agent/Owner
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.
Value
Owner) HENRY J/JENNIFER L LEMKE Create Date 08/04/2008
Category 500 -Residential-Heating & Ventilating _ Plan
- - ----_
I'I Electric Solar ~ Solid_
~/ 'I Replace ~ ~ Other _~
Steam A/C Vent
Suppl. Con. Burner
Direct Vent Not Aoolicable
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920)236-5084
o1H~
ON THE WATER
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 m fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR ~ __
** Advisory -For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Cuutractvr or IIomcowncr (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIY when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE ~ " 6 ~' ~ D
JOB ADDRESS ~~ ~ ' ~ ~ Ifi ~
CONTRACTOR
CHECK H ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex OMulti-Family
FUEL
^Oil
TYPE
^Forced Air ~adiant
^Electric DSolid
^Solar
^Rental ^Commercial
SYSTEM ^New
^Other
^Industrial
~eplace
^Steam DA/C DVent ^Electric ^Hot Water ^Suppl.
OCon. Burner
IS CHIMNEY BEING LINED ~°~' ^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 DNot Applicable
BTU RATE DAs Per Plan ^Variable ^Other Value ---~~--~
DESCRIPTION !SCOPE OF ALL WORK BEING DONE ~!~-,'--~z~,~~~~',~i~~L ~U 1 L~~
VALUE (Including labor and materials) ~~~~' ~~
I
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~/o~
H
ON 1Hf Y.'AiER
l
I
Cify cf Oshkosh
i}nision oC inspection Service;
215 Chon:h Aeenue I
PO Boz 11)0 I
Oshkosh lV[ 54903-1130
Offttt 920-236-i0~0 I
Fas 920-235-50Sa ~
I (We) t ..r ~~;~
~-~
{Address)
Electric Installation
Verification
__} ~ ~~
(Electrical Contractor Name)
(City)
s ~' `_ ice'-~ t I' ~ -
(State) (Zip Code}
have been contracted to perform
at the following address:
is installation work for ,/7i~i? /l /~~~~~ ,
~ (Name of party contracted to)
I y ~`
(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 Heating Plant and/or AIC 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 lighting fixtures due to siding / soffit installation. Note: New Service
` Entrance Cables will require a separate permit.
_ _ Reconnection or new circuit far the replacement of outer pernianently wired
appliances / fixtw•es. j
New circuit for the addition of A,~C to an individual dwelling u~Zit (house or the
individual systems in a duplex or condominiumj, including required service
electrical outlets. !,
Other I,
i
I!
The value of this work is ~~~. ~d ~
il~
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection /installation will be done in compliance with manufacturer and Electric code
reau~rements.
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(Signature ~f ~on~pany Officer)
d
{Print Name of Officer)
~~ ~~ _
(L?ate)
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