HomeMy WebLinkAbout0133602-HVAC (furnace)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 106 W 9TH AVE Owner ROBL PROPERTIES LLC
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature r
of Work
No 133602
Create Date 10/16/2008
O'NEILL ENTERPRISES INC Category 500 -Residential-Heating & Ventilating Plan
/ Gas Oil Electric Solar Solid ~
^ New ^/ Replace ^ Other ~
/ Forced Air Radiant Steam A/C ~ Vent
Electric Hot Water Suppl. Con. Burner
Chimne A Chimney B Direct Vent Not Applicable
As Approved Existing Not Applicable Value
As Per Plan Variable Other i Value
signeo by home
Fees: Valuation $1,800.00 Plan Approval $0.00 Permit Fee Paid
Issued By
^ Permit Voided ~
$37.00
Date 10!21 /2008
Parcel Id # 0301160000
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 522 W 6TH AVE OSHKOSH WI 54902 - 5916 Telephone Number 230-2007 (office)
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.
10/15/2008 16:57 FAX 19202302008 ONEILL ENTERPRISES
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)23fr5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
I~ 001/001
• Application(s) and fee(s) can be brought to City Hall, Room 20S or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I ou are n r r ar ' ti the P r ount an v a e u nds k here
anith' roc throw our ount
** Advisory -For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) mast be sabmitted
with the permit application. Applications submitted without an F.IV when sack is required, wBl not be
processed for Permit Issaance and w>71 be returned for completion.
DATE V
II-- `,'
JOB ADDRESS ~ ~ ~] ~(~(J , ~~ ~ U .
OWNER__ (~~~ ~1~~
~f/PAS
//
CONTRACTOR ~ ~f/1 , ,$ /'tC',
CHECK fid ALL APPLICABLE
USE CATEGORY
^Single Family "l~Duplex ^Multi-Family G~Rental ^Commercial ^Industrial
FUEL l~Gas ^Electric ^Solid SYSTEM ^New i~Replace
^Oil ^Solar ^Other
TYPE
~orced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIIVIlVEY BEING LINED~(No ^Yes - LIAiER SIZE & MANUFACTURER
Note: All chimneys sha[1 be sized per the BTU's being vented.
CHaVIl~TEY TYPE ^Chimney A ^Chimney B Direct Vent ^Other
HEAT LOSS OAs Approved Existing ^Not Applicable
~
BTU RATE DAs Per Plan ^Variable (
p~000
Other Value ,
DESCRII'TION /SCOPE OF ALL WORK BEING DONE
VALUE (including labor and materials) ~ ~ ~ ~~
~~.~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ~~y~E ~ itv ~~ ~ I t/ ~Jt~"~-y
~:~! 2iCF1 ~
02 3 ..y~,~ ~ ~ / o,io~
c~~aoo~
~u~ E. 1J!-' i~:99Ah1 ~rs~d ti~an ;+ vac::
Cyr oraw,a
a~au W h~eMlre,
717 t.">,wW Aram
r'O MA 1110
OdlwbMl !NO]•11
Offer 3tV73~d0A0
FY YZP77M7011
E tric stallation '~
(El 'cat Contractor'
(Aderees) - (City)
hllvc beca contracted to pert ~ el iattal l~ttloa wOr
at the fotluwuig addrods: -
when wor
?he aature of the work consi of ( ~ One or Descri
x I
Recottt»ction or c' for replacerneot
~^ Recoanection or. ew circ for rcplscarncpt
water heater. ~
Reconnection oti, a Sc~i Entrance Cable
and lighting tares d to siding ~ soffit
Bntrauce Cad wii} a separate pl
Reconnection or' cw cite for the replacem
appltaaceb / es.
~Tew circuit for additi of A/C to :ta lndi
individuals ie n lcx or condom
elecvical
~_ Other
N: ;E3B
(State) (Zip Code)
~ ~ra eC~~,'e 5
of party contract to j
~~
v~ be ormedj
the Ns ¢ of Work)
latittg P t and<'or A/C Condenser.
ectric tar F~earsr or power veiltcd
efer 90 +rltcrationx to recerptacles
itatl8a Tote: New Sesttice
lit.
ofo permanently wired
dal d my unit (house or the
gun j, in uding required iervicc
The value of this work is S ~ ~ ~y
thereby verily rhts work will perf by an employ f this
the rc:conncctiou ~ irutallation bed incompliance t~xaz
requirements. ,
Comppny
eaG further venfy
and Electric code
(Print Nacpe o t'flcer) (Date) ~'~
spot