HomeMy WebLinkAbout0132733-HVAC (furnace) CITY OF OSHKOSH No 132733
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 705 OREGON ST Owner JULIE PANSKE Create Date 09/08/2008
Contractor CUSTOM HEATING & COOLING Category 510 -Ind. &Comm-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System New _ _ _ ~ ~/ Replace ~ ~ Other
/ Forced Air _~ Radiant Steam ~A/~ Vent
Electric _ Hot Water Suppl. Con. Bumer
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 70,000
Use/Nature OMM /REPLACE FLOOD DAMAGED FURNACE, EIV SIGNED BY HOEHNE ELECTRIC "check #9727
of Work
Fees: Valuation ~ $1,700.00 Plan Approval $0.00 Permit Fee Paid $35.50
Issued By: ~'~-~ Date 09/08/2008
Permit Voided
Parcel Id # 0900300000
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 1503 S MAIN ST__ OSHKOSH Wl 54902 -6911 Telephone Number (920) 235-7263
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 SEP 0 8 2008 HK .f H
Fax (920)236=5084
...., DEPARTMENT OF
DEVELOPMENT pN THE WATFR
.. HVAC PERMITI~X~~,i~-~IDIVisION
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 ] 128,
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
!f you are a contractor particiDatinQ in the Permit fee Account Svstem and have adequate funds, check {,erz
ou want this processed through vour.~account
** 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 returned for completion. ~/
DATE ~~ ~ O
JOB ADD
OWNER
CONTRACTO
J
CHECK ~ ALL APPLICABLE
SE CATEGORY
~ingle Family
D
~~
J
^Commercial
^D}~plex ^Multi-Family ^Rental
FUEL .Eras OElectric OSolid SYSTEM
^Oil OSolar
TYPE
~orced Air ^Radiant ^Steam ^A/C ^Vent ^Electric
IS CHIMNEY BEING LINED~No ^Yes -LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ~C-himney B,
HEAT LOSS OAs Approved OExisting
BTU RATE ^As Per Plan ^Variable
DESCRIPTION /~OPE~F ALL WOR~~EIN~G DONS
VALUE (Including labor and materials)
^New
^Other
^Industrial
^Replace
^Hot Water ^Suppl. ^C n. Burner
L~~C.(JC,
& MANUFACTURER ~
^Direct Vent ^Other
^Not Applicable
^Other Value
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
R~IUE®
City of Oshkosh
Division oflnspectionServices SEP 0 8 2008
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130 DEPARTMENT OF
HK H Office 920-236-5050 COMMUNITY DEVELOPMENT
ON THE WATER Fax 920-236-5084 INSPECTION SERVICES DIVISION
Electric Installation Verification
I (We) ~ ~ ~~
(Electrical Contractor Name or Homeowner's Name)
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
7 Or
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 A/C 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 for the replacement of other permanently wired
appliances /fixtures.
New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi-use building would require a licensed Electrical
Contractor.
Other
~'
The value of this work is $ ~~~
I hereby verify this work will be performed in compliance with the License requirements of
Section 11-22 of the Oshkosh Municipal code and further verify the reconnection /installation
will be done in compliance with manufacturer and Electric code requirements.
!/~ U/Z,~-is l-~~~C
(Signature of Company Officer or Homeowner) (Print Name)
~~~/~
(Date)
07/07