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HomeMy WebLinkAbout0132731-HVAC (boiler) CITY OF OSHKOSH No 132731 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATE R Job Address 2748 OREGON ST Owner LEE W/SHARON L BAKER Create Date 09/08/2008 Contractor CUSTOM HEATING & COOLING Category 500 -Residential-Heating & Ventilating Plan Fuel /^ Gas Oil ~ Electric ~ Solar Solid System ^ New ~ ^/ Replace J 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 140,000 Use/Nature FR /REPLACE FLOOD DAMAGED BOILER, EIV SIGNED BY HOEHNE ELECTRIC **check #9727 of Work Fees: Valuation $3,900.00 Plan Approval $0:00 Permit Fee Paid $68.50 Issued By: Date 09/08/2008 ^ Permit Voided Parcel Id # 1412560000 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 WI 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 pertormed within two business days from the time the project is ready. City ofOshkosh ~~~ ~'~~D Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 ~Ep 0 8 2008 Phone (920) 236-5050 Fax (920) 236=5084 DEPARTMENT OF •' °•~ COMMUNITY DEVELOPMENT _ HVAC P~~fI~~L~SG~1~Y~~N All information after bold categories must be provided. Incomplete applications will not be processed. HKOf H ~b ON THE WATFR // ~~~~ lS~ • Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1 128, 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 if you are a contractor ~articiDatinQ in the Permit fee Account Svstem and have adeauate funds, check here it you want this processed through your. 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 ~~~ JOB ADDRESS d / 7'"~ ~~~" `~~ O CONTRACTOR ~u-°'~Y CHECK D ALL APPLICABLE USE CATEGORY 'Single Family ^Dyplex OMulti-Family R ^Rental ^Commercial ^Industrial FUEL bias ^Electric OSolid SYSTEM ONew ~.eplace ^Oil ^Solar ^Other TYPE ^Forced Air ^Radiant OSteam ^A/C ^Vent ^Electric ~Iot Water ^Suppl. ^Con. Burner IS CHIMNEY BEING LINED~AIo OYes -LINER SIZE Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ~himney A ^Chimney B, HEAT LOSS OAs Approved existing BTU RATE OAs Per Plan ^Variable DE~~ON /SCOPE OF ALL WORK~Oi /~/l~ VALUE (Including labor and materials) 4~Iv1ANUFACTURER ^Direct Vent ^Other ^Not Applicable ^Other Value ~~ ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) RECE Ci of Oshkosh ' ~E Division of Inspection Services Q 2004 ty SEP 0 215 Church Avenue O 0 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) ~/7 ~~ ~ n~~i ~~ 1L~rt ~` ~~~3 (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: ©re (Address work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) ~C 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 $ ,/moo 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. ~(~`r.~~ ~/1 h (Signature of Company Officer or Homeowner) (Print Name) (Date) 07/07