HomeMy WebLinkAbout0132168-HVAC (furnace)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1020 JEFFERSON ST Owner JEFFREY R BARTELS
No 132168
Create Date 08/11/2008
Contractor MARK WEBER HEATING & COOLING IN 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 Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Appligble Value
BTU Rate As Per Plan Variable Other Value
Use/Nature. FR /Replace furnace. EIV signed by Electrical Construction Services. **debit acct . .
of Work
Fees: Valuation $1,500.00 Plan Approval $0.00 Permit Fee Paid $32.50
Issued By: ~) Date 08/11/2008
^ Permit Voided
Parcel Id # 1001760000
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 1075 ISLAND ESTATE CT OSHKOSH
WI 54901 -1341 Telephone Number 235-1523
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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 Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
j ^Rental ^Commercial
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
[ncomplete applications will not be processed.
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• Application(s) and feels} can be brought to City Hall; Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1 I28. Commencing work without permit(s) wilt result in fees being doubled or X100.00 plus the
normal permit fee, which ever is greater.
OR i ~ _ - .
** Advisory -For applicable projects, an Electrical Installation Verification (ElV) 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. Q
DATE ~ " l ~d
_/
JOB ADDRESS ' ' / ~~~ ~ SON
~~ ~~
OWNER
CONTRA
CHECK Q ALL APPLICABLE
USE CATEGORY
Ingle Family Duplex ^Multi-Family
FUEL ~as ^Electric ^Solid
^Oil ^Solar
TYPE
~orced Air i]Radiant OSteam ^A/C L7Vent
IS CHIMNEY BEING Lll\TEll 11~ ^Yes -LINER ~Sh
Note: All chimneys shall be sized per the BTU's being vented'.,.
CHIMNEY TYPE t~Chimney A ^Chimney, B
HEAT LOSS ^As Approved DExisting '',
BTU RATE ^As Per Plan OVariable
SYSTEM ^New
^Other
~.IHK.IH
ON TriF ~NATFR
^Industrial
eplace
^Eleetric OHot VlVater ^Suppl.
~E & MANtiFACTUREK
ODirect Vent ^Other
Not Applicable
^Other Value
DESCRIPTION l SCOPE OF ALL WORK BEING DONE ~f~L '~ ~_5~T~,,~ rte' ~STiIt~
/c :~
VALUE (Including tabor and materials) ~ TO ~~ •'~~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
C1Con. Burner
o~oo
Cifyorosnl;o~n
Division of Inspection Sgrvic~s
215 Church Avenue
PO Sox 1130
Osnlcosh Wi 54903-! 130
~.--) O~ue 920-235-5050
ON iH vrnr6tt Fax 420-236.50&4
Electric ~nsta~lation Verification
(Electrical Contractor Name)
(Address)
have been contracted to perform electric
~~ °~ ~
at the following address:
(City}
(State) (Zip Cade)
ion work for ~~32K d~ ,
(Name of party contracted to}
i~h ~4'~
{Address where work will be performed)
The nature of the wark consists of {Check One or Describe the Nature of Work}
~!~ Reconnection ar new circuit for replacement Heating Flant and/or A/C Condenser.
Recaiuiection ar new circuitifor replacement Electric Water Heater or power vented
water heater,
Recannection of the ;ervice~Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures dueto siding ! soffit installation, Note: New Service
Entrance Cables uJill require a separate permit. d"
_ Reconnection or net~.r circuit';far the replacement of other permarxently wired
appliances !fixtures. ~ -.
New circuit far the addition of A,~C to an individual dwelling unit {house ar the
individual systeans in a duplex ar condominium), including required service
electrical outlets-
Other
The value of this work is $ ~~D `
I hereby verify this wark will be perfi
the reconnection /installation will be
requirements.
C~
y
(Signature df~aml~any Of>;cer)
by an employee of this company and further verify
in compliance with manufacturer and Electric code
,a
{Print Name of Officer)
{Date)
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