HomeMy WebLinkAbout0132502-HVAC (furnace) CITY OF OSHKOSH No 132502
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 1321 BROAD ST Owner GWENDOLYN M PEARSON Create Date 08/26/2008
Contractor THOMPSON HEATING AND COOLING S 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. Bumer~
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value 54,000
Use/Nature FR /REPLACE FURNACE, EIV SIGNED BY T RUCK ELECTRIC *"check #1862
of Work
Fees: Valuation
Issued By:
Plan Approval $0.00 Permit Fee Paid 1 $47.50
^ Permit Voided
Date 08/26/2008
Parcelld # 1506180000
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 901 OTTER AVE
OSHKOSH WI 54801 _5444 Telephone Number 920-426-3095
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O.lHKO.IH
ON THE WATFR
• 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 fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account Svstem and have adequate funds, check here
if you want this processed through your account n
** 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 without an EIV when such is required, will not be
processed for Permit Issuance and will be retarned for completion.
DATE ~/Z ~O~
U E CATEGORY
Single Family ODuplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ~as ^Electric ^Solid SYSTEM ^New ^Replace
^Oil ^Solar ^Other
TYPE .
Forced Air ^Radiant OSteam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED I~io ^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 ^As Per Plan ^Variable [Other Value ~~5~/ ~~
DESCRIPTION /SCOPE OF ALL WORK BEING DONE ~~,~-~ ~---CJ ~
VALUE (Including labor and materials) $ ~~f ~ .- ~y
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ,/~~(le___ ~ /
o~~o~
CHECK 0 ALL APPLICABLE
~-~1
~ ~7CY Of-DSIL~i 0311
~
~ Division of-Inspection Services
~ 2li Church Avenue
\
,.~ PO Bps 1 [ 30
_.~
~ ~ ~~
i Ostti:osh »,~I 1.1903-i 730
~~:: I'""~;~~~1~~- Office 9~t?-"'a-5050
po-i T~; ..; nr=; Fux 9%0-336-5034
Eiectr~c installation ~crification
z t j~v~~~: ~~ ~~~~~ ~ ~~
~l;lectrical Contractor Name)
(Address? -------- ____. Cit
~ Y) {Mate)
h=~'e ~e;n cents:ct,°;1 to -~erforrrt eiF;ctt-ic installation work for
at size _~:ion%,n~ :~.d~!.z-~ss:
(~ ~ i. Asa e'
(`11ame of party cont~ act~;;~ tc~ ;~
(Address where ~~Tork will be performed)
T ~_e. suture o'tse E~-ori;. e~nsasts :~f: (C'heck One or Describe the Nature of Work)
Recorirzectiozz ar ne~u circuit for replacement Heating Plant and/or A/C Conrozlser.
Recoraiectioz7 0= ~~e,~~ ~ircz:it for replacement Electric ~UVater Heater or po~~-er ~~ezrte~i
wate_ heater-
_____~ R~;cor~z;,ectzc~~ o `the Service Entrance Cable, Tvleter t3ox, alterations to reccpt~ciLs
gin! lighting fi~~_=arcs dt~e to siding / soffit insl:alla~tion. Note: New Ser~Tice
~;ritra-ncr C'ai7les vv11 require a separate perzriit.
___-._ ~eco~~t7e z.,;1 or zz~ti~,- circui~ for the replaceir~ent of other permanently ~~ir ~~r
~aJ~1Ja1~r1Ce5 / yi3~tures.
- :Ae~~ c:;rcu,+.t for the ~;ddition of A/C to an individzaal a:hi~elling unit (house c~r t~~~~;
7~1Ci ~ridu3l SySt%3:i1S In ~ clupleX OT Coi.7.C[?~;_ni iwinaly '-!~Cltzdintr reR"'r°.~ „~" ~,;:.
e, ea;tl~Cd1013.11etS. ° ~"`
__- ~~'th~~1'
~,h~ v<<:~4:z of this „yc;rk: is '~~} ~, Q!?
I h=z-~~ ~ .t, Az-zfy lr_., ~ z~ ~k ,rile b~ ceri:orme
tze sec ~ d by ~ employee of this company and further ~ ~~r~r,~>
~17ec zo~7 i zrzst~l::atior, ~~zll be dome i~7 complzance with manufacturer and Electri ti.~de
£'GUirE r;~~;~ts.