HomeMy WebLinkAbout0132545-HVAC (furnaces)/~"~ CITY OF OSHKOSH No 132545
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 933 MALLARD AVE Owner CHARLES A/MARILYN J PERRY Create Date 08/28/2008
Contractor MARK WEBER HEATING & COOLING IN Category 510 -Ind. i£ Comm-Heating 8~ Ventilating Plan
Fuel / Gas Oil ~ Electric Solar Solid ~
System ^ New ~ [/] Replace ~ ^ Other J
/ 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 Applicable ] Value
BTU Rate As Per Plan Variable Other ~ Value
Use/Nature
of Work
AULTI-FAMILY (UNITS 1-4) /REPLACE FURNACES, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES (Greg Davis) **debt
icct
Fees: Valuation
Issued By:
Plan Approval $0.00
^ Permit Voided
Date 08/28/2008
Parceild # 1514819706
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
Agent/Owner
Date
Address 1075 ISLAND ESTATE CT OSHKOSH WI 54901 -1341 Telephone Number 235-1523
To schedule inspections please call the Inspection Requbst 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.
Permit Fee Paid $76.00
City of Oshkosh
Division of Inspection Services
P.O. Box i li0
Oshkosh, W 54443-1130
Phone (920) 236-5454
Fax (924) 236-5031
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
QJHKOfH
ON T~-1~ WATFR
* Application(s) and fee(s) can be brought to City Hail, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I 128. Commencing work without permits} will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
oR
** Advisory -Far 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 EN when such is required, will not be
processed for Permit Issuance and will be retarned for completion.
DATE~G `- O
JOB ADDRESS _L / ~~ ~I19-~L ~~ ~^ ~~ t a ~) 3~ -~'1
OWNER ,~6¢Dfl'l~L~`T ~/2 °~ ~~ ~h~1 `T-~ !~"
CONTRACTOR~~77~ PN~~2 ~ _
CHECK H ALL APPLICABLE
USE CATEGORY
D5ingle Family ^Duplex ~Ylulti-Family ^Rental ^Commercial DIndustrial
FUEL J~Gas DElectric DSolid SYSTEM ^New ~eplace
^Oit DSolar ^Other
TYPE
forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric DHot 1~Vater ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINEll ~~ ^Yes - LIi~1ER SIZE
Note: A]I chimneys sha[1 be sized per the BTU's being vented.
CHI111NEY TYPE DChimney A ~himney B
HEAT LOSS DAs Approved ^Existing
BTU RATE ^As Per Plan ClVariable
^Other
DESCRIPTION /SCOPE OF ALL WORK BEING DONE /~~./~~~~ _ % d,>~ ~1 ~~ oliL
b'ALUE (Including labor and materials) S L~~~f~ .
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
& bIANUFACTURER
DDirect Vent
DNot Applicable
DOther Value
Q?!u;"
i.i:v of Os't:ncr>h
ihr;+rnt of iaslrectaas Sen~tca~>
'_I~ taturck ~resas:.
`~... OshS:osh1:'t 519J3-I?30
~` i ~ Ot&~c "12(x-'36-iuiiF
~J1 ~~
aw ~~~: a-nre'+ }', x 4_'Ik?'s6-545q
~:lectric ~nst~~[atiQ~ ~~ri~cat~z~n
1 (YV V) `ii... ~ ' . ~'~l~t ~~ ~4 rre ~..+ ~i_ j ~'.... ' -( ~S ~~ ~ 140 :-~. i '. ~ ...~._.......»
(Electzical Contractor dame)
:.
~ -- .. ~ - -
(Address} (C~ty} (State) (Zip Cocle}
have been contracted to perl~3rn~ electric installation ti~~ar~ for,-!~ Gti~~~t'I ~~~~ 1
(l~tan~e ofparty contracted to}~
at the follo~}~ing address. _~~_~~~/~~~~ _ /47~T / ~ 2 ~ ~.~~.__.~~_____. __
{Address «It~er;: ~~-orl ~~~ili be performed}
`l'he nature of'thc t~rork consists af: (Check Qne or I3escribe the Nature of 4~orh}
__ ~ Reconnection or new circuit for replacement Heating Plant and/or A1C Condenser.
I~eeonnc.ction or s~c~~- circuit for replacement Electric Water I-~e:ater or power veiltec!
--~--- ._ ~~rater heater.
Reconnection of'tl~e ~er~Fice: Entrance Cable, Meter Bax, alteration.4 to receptacles
__~_ and lighting; 3ixttfres clue to siding l soffit installation. Note: New Service
l~ntranc:e Cable, ~ ilI require a separate pert~2it.~
Rccc>nnectioc~ or rtr.~,~ circuit for the replacement of oilier pern~anently r~rired
------ apphanc~~~ r' fixtures. .
?ti~e,~~r circuit for th~...cddition of A>'C to am individual dwelling tenit (house or the
--~-- individual s~~strt~t~s i~~ a dcipl4x cam' condominium}, including reduired service
nlectt~cal c~utlr:•ts.
Cjther
"The ~~alue <~('this ~~.c~rk is ~;_-~~Q ~~(~____
I hereby verify this work .~+~ill lac her~fi~,med t~~t <cn etr~ployee of this corr-p~~y and furtl~et` verity
the reconnection / installation will be dcme in compliance ~~rith manufacturer and Electric code
rcctuireti~ents.
g' ~ ~D~
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(Si~r~~~ttur.. ~~f C;c~ni~zai~;, (.~llic~:t j {Print N~n7~e ot~ C)i~c~r} (Date)
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