HomeMy WebLinkAbout0133418-HVAC (furnace)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1812 HOLLISTER AVE Owner PATRICIA A HELM POESCHL
Contractor
Fuel
System
Chimney Type
Heat Loss
'~ BTU Rate
Use/Nature
of Work
No 133418
Create Date 10/10/2008
MARK WEBER HEATING & COOLING IN Category 500 -Residential-Heating & Ventilating Plan
/ Gas Oil Electric Solar Solid
^ New ~ ^/ Replace ~ ^ Other
/ Forced Air Radiant Steam A/C Vent
Electric Hot Wate~ Suppl~ Con. Bumer
Chimney A Chimney B Direct Vent Not Applipble
As Approved Existing Not Applicable Value
As Per Plan Variable Other Value
FR /REPLACE FURNACE, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES LLC (Greg Davis) "'debt acct
Fees: Valuation $1,200.00 Plan Approval $0.00
Issued By:
^ Permit Voided
Date 10/10/2008
Parcel Id # 1200350000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
White 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 Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Finai, 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.
Permit Fee Paid $28.00
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920)236-5084
HVAC 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
** 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
Z
01HK0 H
ON THE WATER
CHECK ®ALL APPLICABLE
USE CATEGORY
,mingle Family ^Duplex ^Multi-Family
^Rental ^Commercial
^ Industrial
FUEL bras ^Electric OSolid
^Oil ^Solar
SYSTEM ^New
^Other
~eplace
TYPE
[Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED,~ia^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE OChimney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved ^Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable ^Other Value
/ SCOPE OF ALL WORK BEING DONE ~g~C~4-P~ -'~~-~ ~;c ~~
VALUE (Including labor and materials) $ ~~`) . ~`)(')
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~~o~
CONTRACTOR_ /mil /3'1.r,.f I ®~-~
City of dshkash
Di+tistan o[lnspeciion Sen~ices
215 Church Avenue
PO Box 1130
v`~_,~ Oshkosh VJ1 54403-1130
fl Jft~j(1/`1(~_", JJ~~ dt[ue 920-23b-SOSU
ON 7M wni[a Fax 42U-?36-50&~4
Electric ~nsta~lation Verifcatian
(Electrical Contractor Name)
(Address) (City) (State) (Zip Code}
have been contracted to perform electric installation work for~1 L•t/ ,, ~f-/'~ ,
{Name of party contracted to)
at the following address: ~ D ~ ~' ~"~y ~ L t 4,~Z--~
(Address where work will be perfornaed}
The nature of the work consists of: (Check One or f3escribe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant andlor A1C 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 ne«f circuit far the replacement of osier permanently t•vired
appliances /fixtures. •
New circuit for the addition of A,~C to an individual dweltirrg unit {house or the
individual systems in a duplex or condominium}, including required service
electrical outlets.
Other
The value of this work is $ ~~~ - ~(~
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection !installation will be done in compliance with manufacturer and Electric code
requirements.
~' .
(Signature e~f ~ampany Officer} (Print Name of Officer} GG" V (Dl/ate) .
S/02