HomeMy WebLinkAbout0132169-HVAC (furnace) CITY OF OSHKOSH No 132169
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 403 E NEW YORK AVE Owner VERONA A LOH 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 J ^/ Replace _ _ ^ Other ^
^/ Forced Air Radiant ^ Steam ~ ~C i ^ Vent
Electric j ^Hot Water J ^ Suppl. I ^ Con. Burner I
Chimney Type ~himney A _ Chimney B _ ~ Direct Vent Not Applicable _ J
Heat Loss - - --
L As Approved _ ^ Existing. _.
Not Applicable ~ Value
BTU Rate - - -
As Per Plan ^ Variable - - --
Other I Value
Use/Nature S FR /Replace furnace. EIV signed by Electrical Construction Services. "debit acct
of Work
Fees: Valuation $1,600.00_ Plan Approval __$_0.00 Permit Fee Paid $34.00
Issued By: ~}~/J Date 08/11/2008
^ Permit Voided Parcel Id # 1008570000
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
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.v. Box I 130
Oshkosh, ~VI 5440.3-1130
Phone (92U) 236-500
fax (920) 23b-084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
[ncomplete applications will not be processed.
ofHKO ~~--~
ON Tt-iF `rVATFR
• Applications} and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Bax 1128,
Oshkosh WI 51903-1128. Commencing work without permit{s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
!stem and have adequate ~inds check here
** Advisory -Far applicable projects, an Electrical Installation 'eriticatitm {EIS`) form, signed by ttte. E.lettrical
Contractor or Ilomeawner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such i required, will not be
processed for Permit Issuance and will be returned for completion. ~^~
s ,,~,~>
,1013 AI~DIZI~:SS----~l~ ~ ~ ~! ` ~_ _~~~ ~ --._.
CONTRACTOR__I~°~/'~7r/'~ f~;.a'~
CHECK C/r ALL APPLICABLE
US + -ATEGORY
tngle Family Duplex ^~iulti-Family ^Rental
FUEL ,~'('ias ^Flectric ^Solid SYSTEM
L~0i1 OSo1ar
O Industrial
~'~Replace
"I'lr'PE
'~orced Air Radiant !]Steam ^A/C !]Vent ^Electric ^Hot Water ^Suppt.
I~5 CHIMNEY BEING LINEDo OYes - LL'vERSIZE & ?vIANUFACTUh.ER
ivote: All chimneys shall be sized per the f3Tli's being vented.
CHI1'INEY TYPO: Chimney A ^Chimney B
HEAT LOSS ^As Approved ^Existing
BTL' RATE ^As Per Plan ^Variable
^Other
^Con. Burner
DESCRIPTION /SCOPE OF ALL WORK BEING DONF. ~1~ ~ a~ ~~~t
ODirect Vent
Cllti`ot Applicable
^0ther Value
VALUE (Including tabor and materials} 5 ~ ~"`~~
ELECTRICAL CONTRACTOR (for projects nat requiring an EIV Form)
^Cammercial
^Other
o~io,
L:isv of U>h;:ash
Oirision of Isss)mct~ua Sen•irti
215 Citarch Avnsut
PU flo>; t t 70
QsF~Fs~sh \V 154903 - I ! 30
O ~~( ~--~ ofGcc Y?0-23b-~OSE>
ON f114 v: Al EN ~ s Flx 92J 2fG-SOEd
Electric ~nstalla?tion Veri;~ca#ioo
(Electrical Contractor Name)
(Address) (City} (State) (Z,tp Code)
have been contracted to perform electric installation work for /''~~,~ ~~~~,
(Name of party contracted to}
at the fotlowing address: _--_~~~~__._--_-_-- ~. ~ y fir? f~
(Address where work will be performed)
The nature of the ~~rork consists of: (Check One or Describe the Mature of. Work)
_~ Reconnection or new circuit for replacement Heating Plant and/or AfG Condenser.
__~ Reconnection or ne~v 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 s~~iil require a separate permit.
Reconnection or ne~v circuit for the replacement of other permanently ~•vired
appliances !fixtures. -
New circuit for the additian of AlC to an. individual dwelling uftit (house or the
individual systems in a duplex or condominitun), including required service
electrical outlets.
C~iher
fhe value oCihis ~~-ork is ~~_Q~
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection 1 installation will be done in compliance with manufacturer and Electric code
rcqulrements.
s~ t:
,~.. ~_ ~,
- s ~ - - ~,
(Signature cif Company Officer) T (Pri12t Name of Offcer} (Date)
slut