HomeMy WebLinkAbout0132779-HVAC (furnace & a/c)I'~ CITY OF OSHKOSH No 132779
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 515 CONGRESS AVE Owner MARK/MARILYN DORSCHNER Create Date 09/10/2008
Contractor BLACK-HAAK HEATING Category 502 -Residential-Both Plan
Fuel / Gas Oil Electric Solar ~I Solid _j
System ^ New ~ ^/ Replace i ^ Other
/ 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 SFR /Replace furnace and a/c. EIV signed by homeowner Marilyn Dorschner.
of Work
I
Fees: Valuation $7,300.00 Plan Approval $0.00 Permit Fee Paid __ $119._50
Issued By: ~/J'y//('~ Date 09/10/2008
^ Permit Voided I Parcel Id # 1208470000
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 PO BOX 7075
APPLETON WI 54912 -7075 Telephone Number 920-757-9990
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.
Ctq of Oslilcosl~
~tvislon of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
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ON THE wATF.R
HV,AC PERMIT APPLICATION
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 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or 5100.00 plus the
normal permit fee, which ever is greater. ~ '
OR ~ -- ~ ~ -
DATE q I ~, I rig
U E CATEGORY
Single Family Duplex Multi-Family
FUEL Gas ^Electric ^Solid
^Oil ^Solaz
TYPE
Forced Air t]Radiant ^Steam ~A/C
~~~~ ?~g~
Rental ^Commercial Industrial
SYSTEM New
^Other
Replace
[]Vent ^Electric I~Hot Water ~Suppl. ^Con. Burner
IS CHIlVIlVEY BEING LINED~io Yes -LINER SIZE & MANTJFACTiJRER
Note: All chimneys shall be sized per tthhe BTU's being vented.
C~Ey TypE ^Chimney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved xisting Not Applicable
B~ g~,~ DAs Per Plan ariable Other Value -
OF ALL WORK BEIN
VALUE (Including labor and all materials including light fixtures) 5 ~~oo ' ~O
ELECTRICAL CONTRACTOR 'f1C) P.~ PX
~ For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Elec • ~'
~,
' ~
SEP 0 5 2008
9/az
DEf'ARTf~ktN i Cji-:
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
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CHECK ~ ALL APPLICABLE
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U:wa;on m ImpeOtias: Seniro:
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Electric Ynstallati~n Z'erifieation
t (W~)
;St~~toj
(Zip (;:ode)
accept the respocL~ibilit}- ra perform the electric work as stared below, at the following address:
tr. 1 G. ~ n ~ ,
wltzre v~rork will be
Tt1e nature o' the work cansists of: Check Cane or Doscribe the 1~'ature of ~~~ork)
Rea~nncctia;t or ntw circuit for replacement H9ati:ng Plant al~d/or A/C Condenser.
__ Recannectian or new ~irct2it for reptacement Electric W'okx Neater or po~vcr vented
ti'','OtCr hC>Stdr,
_,.,._.•.~, Reconnecdun afthe service Entrance (:able, Meter Ica; alteration9 to receptacles
and lighting tixt~s due to siding / suit instaltation. Note: Naw Service
Etatrancc Cables will require a scparaze permit,
-.-_ p.ecunnec;tion Gr new circuit for tlae replacernant of other permanentt~~ wired
appliances ~ fixtures,
.,~ i*(ew eirct:it far the addition of A/C to axY indivtclual dwelling u>•rr'r, including
required :eervie~ CJectrica'1 cutters. lYute: f.'amenwners r.'an only da t.~terr vwr
electric on a si„gle,jamriy ol~lrer occuprarl home. 6Yut;i, p/r a condominium,
duplex, rehtul: or mpltr-use hultding wquld require a lice-tsad Electrical
contractor.
~._._ Qtnar
"fhe valtu of this wort.:s $ ~~_
I liere~i~ verify this work Vvill be performed in c.~mpliance with the License requrements of
~ecGon 1 i-22 or'tbe Oxhkcsh Mur9icipal cods and t'urther verify-the recorul<eGUcm; tnstalla:ian
~,ti~ill h~ done in, compliance r~vith ;ranufacturer arad Eleatriv Code requirenaeats.
SialnrLU~e of C ady 011`'icer of tdomeovuner~ ( nt Name (n tc)
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Z0 3tJt7d Z666L5L0Z6 6990 800Z/60l60
(Electrical Contractor N$rne or Iiomco~vner's Name j ~"