HomeMy WebLinkAbout2008-HVAC (furnace & a/c)/~ CITY OF OSHKOSH No 133589
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 816 WASHINGTON AVE Owner SRDAN D/RENAE D RELJIC Create Date 10/20/2008
Contractor DRUCKS PLUMBING ~ HEATING CO IN( Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System a New ~ ^/ Replace ~ Other
/ Forced Air Radiant Steam / A/C ~
~~ ~__ _ - ~
Q _____
Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent ~ Not Applicable _ ',
Heat Loss As Approved Existing ~~ Not Applicable _ __ ,I Value
BTU Rate As Per Plan Variable Other ~ Value
Use/Nature
of Work
'LACE FURNACE AND A/C, ALSO INSTALL MINI-SPLIT
PLBG, HVAC & ELEC *'check #62874
THIRD FLOOR, EIV S
Fees: Valuation $16,500.00 Plan Approval $0.00 Permit Fee Paid $225.00
Issued By: ~~-- Date' 10/20/2008
^ Permit Voided
Parcel Id # 1101200000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the Ciry strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address P O BOX 355 MENASHA _ WI 54952 - 355 Telephone Number 920-426-2654
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Ja
ZZ~'
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
oCr 2 0 200$
qq''~~ i`.. - .~^;~,..£ :.rte nI
v,.4„F '31,`1 .lid ~ , ~.. 1. fP"~ r L.\. ~''~)~~'!1"I~~
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
01HK0-IH
ON THE WATFR
~ 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor varticipatinQ in the Permit fee Account Svstem and have adequate funds. check here
i~you want this processed through your account
** Advisory -For applicable projects, an Electrical Installation Verification (EIV) foam, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications. submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE 9' -~ ~ 7 --0 ~
JOB ADDRESS ~l (o /~C~s l•F err ~ ~ ~ U~~
OWNER jZt~IJA~ K.-~Z.T«
CONTRACTOR ~t2uct~s Qu.z,~ ,~- ~6rc-~~
CHECK d ALL APPLICABLE.
USE CATEGORY
(Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ~aS ^Electric. !]Solid SYSTEM ~Tew 1$Replace
^Oil OSolar ^Other
TYPE
Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINEll ~No ^Yes, -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B
HEAT LOSS DAs Approved (Existing
BTU RATE ^As Per Plan l~Variable
^Other
DESCRIPTION /SCOPE OF ALL WORK BEING DONE
~"PtACt'" (^VIVV~ /`~ Ct.-~J%XA-L _ 1/~S'l~L~ ~'L( r•y~ - S~°c~T /~ft~+'~i Rra..P
s 4f~hn ~~ 7?f ~ /L 0 _C~c.~3/L
VALUE (Including labor and materials) $ !(e~ ~-~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) . ~It-uctcC
,F~Direct Vent
^Not Applicable
^Other Value _
a~~o~
„q Y" F v_.
.. ~ tip' ,..~
city ofo:nkosn O C T 2 0 2008
Division of Inspection Services
215 Church Avenue ^'~ ~
PO Box 1130 ~ ~ I f y- ~ i. l
Oshkosh WI 54902-1 1 30
O.fHKQfH Office 920-236-5050 ~ ~~ ~~~ ~ • = i 1 ` ~;" ~I'~~
ON THE wnTER Fax 920-236-5084
Electric Installation Verification
(I) (We) ~IL~Ct~g Ruw~~ , i-5/(~r- . LZrz7vt.~ ~ ~
(Electrical Contractor Name)
31 y Af~c=~v ~- ~Gf~,~ wl 5~9sz
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for ~~ E (~~z~r `. ,
(Name of party contracted to)
at the following address: ~ 1Co W,~~N~~~ ~ve,~
(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.
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 other permanently wired appliances /fixtures.
Other
The value of this work is $ soo
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 of Company Officer)
/~'V~Tl" /~~
(Print Name of Officer)
~`t? -~8
(Date)