HomeMy WebLinkAbout0132759-HVAC (boiler)CITY OF OSHKOSH No 132759
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 123 W 10TH AVE Owner AUDREY POMRANING Create Date 09/09/2008
Contractor MARK WEBER HEATING 8 COOLING IN 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
Use/Nature: FR /Replace boiler. EIV signed by Electrical Construction Services. ~*'debit acct ~ .
of Work
Fees: Valuation
Issued By:
Plan Approval $0.00 Permit Fee Paid $55.00
Permit Voided
Date 09/09/2008
Parcelld # 0302200000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applipnt to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1075 ISLAND ESTATE CT OSHKOSH
WI 54901 -1341 Telephone Number 235-1523
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services
P.O. Box 1 13a
Oshkosh, ~L' 5903-1130
Phone (420)236-550
Fax (920) 236-SO$~l
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
[ncomplete applications will not be processed.
a.~N~ofN
oN 7iiF tNATFR
• Application(s) and fee(s) can be brought to City Hall, Room 20S or mailed to Inspection Services, PO Box 1128.
Oshkosh WI 5903-I i28. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
re
art is
cf thr
n
** Advisory -For applicable projects, an Electrical Installation Verification (EIY) 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
proccsscd for Pc.-,iiit ISSUa~,cc and will be returned for completion.
DATE
JOB ADDRESS~~ }~ ',~ D~
OWNER~~~~ ~Qd7~ f'lf~'~~o
CONTRACTOR /'t?I`~ yfi~ ,~7-z Eft
CHECK Ll ALL APPLICABLE
USE CATEGORY
Single Family ODuplex ^Vlulti-Family ^Rental C7Commercial ^Industrial
FUEL s ^Electrie ^Solid SYSTEM l7~tew ~eplace
^Oil C7Solar OOther
TYPE '
^Forced Air ,radiant (]Steam DA/C ^Vent l~Electric OHat Water ClSuppl. ^Con. Burner
15 CHIMNEY BEING LINEll~o ^Yes - L1wER SIZE & yiAi~tUFACTURE
Nate: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE >~himney A CiChimney B ^Direct Vent ^Other
HEAT LOSS ^As Approved ^Existing ^l~'ot Applicable
BTU RATE DAs Per Plan ^Variable ^Other Value
DESCRIPTION !SCOPE OF ALL FORK BEING DONE ~~r.~~~°~~`~ /~~i^~
~,rTt~1 ~ n ~~~ ~: ter- r4 ~,.,~) ~~ ---_ -
VALUE (inrluduig labor and materials) ~_ ~(~~ ~ ~
ELECTRICAL CONTRACTOR (for projects not requiring an E1V Form)
u'%_
'~ :.it=rE.ftJsiuo>h
(~t1`i 1'if Fti!Ste 1, .~~G[': iCi's
t~O!#~, 1I3i1
`~--- i)StuEo5i7 t`J( 5d4U_i_21it;
!~_....._-_~~ L-i
~t r
~~~ i)(SiLC 1771)-?G-:;1-i;i)
~,__
L=.r )Ee~ t%'AIEY Hai 9_'ii-'sG-ill;;.{
Electric I~~talla~ion ~~ri>~ica~~t~~
{Electrical Contractor Nan~ej
.._ r- _
,; ,. ~ E ;
a ~ - , t ~-_ s _ ... __.~._ _ -
(Address} {City} {~taie} {7,ip Code}
have been contracted to l~erf'orm electric installation t.~ork for .~~`~~1'~?~ ~~,
(Name ofpart}~ contacted to}
at the fallowing address: _.~~_._.t~_.____~..Q_~t'` _ _____^ __
(Address wlaer:: wank. will lic; performed}
The nature of the work consists of. {CI~GS;It tJne or I3escribe the Nature of Wolff.}
keconnection or nc«~ circuit i`or replacement )'-leafing l'ta~tt andlor A1C` Condenser.
__.__ 1~.econncction or taeid= circuit for replacement Electric Water 1-ieatcr or pcn~ter venletl
water heater.
_..___,_ Reconnection. cif the; service IJntrance gable, Meter Box, alterations to receptacles
and lighting lixturr3s due to siding I soffit insiallaiion. Note: New Serxrice
l~ntr~r.nce talilcs t~=ill reiluire a separate permit..
-__-_,_ li'e;conncction or n;v:~= circ~~st for the replacement of other permanently aired
alil}liatices I {ixtu~-es.
_~_ ?~dc~t~= circuit for the ~.~dditio~i of Aft:. to ate irrdiviri?ual dwelfing unit (house or the
i-icli~=iduaf s~steni:: in ~~ dui~le:; ~r condraminit~m), including required s~rvicc.
el;,cirical ciutl.ts_
C3tlac;r
'l'llc t~~il~;e ~,l'tliis `:pork is ; - ~~ ~~--
t t,crcby .'~~;r~fiv this wclrk ~. iti t~~; t~e.~ ivr~i~~d ta_v an employee of this company anti fitrther verily
the reconnection installation ~vili bc:. none in compliance with ~manufacfurer a~~cl Electric code
recu~~renients.
-. q~
._. >~
{S~~rE~att,r~: ~~fC='c;t~i,iarty ~~fjic~:r} t:1't-int i~;at~~~ cif C)ffie~r)
C~ g ~
G,_ _~ __.~_~.___.....
{Date)
.i,'U~