HomeMy WebLinkAbout0133642-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
Job Address 1847 MCCURDY ST
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner DAVID D/JANET A ADERMAN
No 133642
Create Date 10/22/2008
Contractor MARK WEBER HEATING 8~ COOLING IN Category 502 -Residential-Both Plan
Fuel / Gas Oil Electric Solar ~
~___~
System ^ New ~ 0 Replace Other
~
- -
/ Forced Air Radiant ~ Steam ~', / A!C
Electric Hot Water ~ ^ Suppl _ _ ^ Con. Burner
himney Type
Chimney A
Chimne B
Direct Vent Not A licable 1
__~
Heat Loss As Approved Existin Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature FR /Replace furnace and a/c. EIV signed by Electrical Construction Services. **debit acct
of Work
I
Fees: Valuation
Issued By:
Plan Approval $0.00
^ Permit Voided
Solid ~,
^ Vent
Parcel Id # 1408450000
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 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.
Permit Fee Paid $58.00
Date 10/22/2008
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.
Z
O1HKOIH
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
** 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.
DATED ` ~~- U 2S
JOB ADDRESS `~~ 7 ~~~~l-
OWNER ~ ~"~~.~~ off'-t~Y}~~'l Dam/
CONTRACTOR~jn9r~ ~ L•>f~ ~~
CHECK 0 ALL APPLICABLE
USE CATEGORY
~ingle Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ,~}as ^Electric ^Solid SYSTEM ^New place
OOiI ^Solar ^Other
TYPE
Forced Air ^Radiant ^Steam ~A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED f~io ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B .~irect Vent ^Other
HEAT LOSS DAs Approved ^Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable ^Other Value
/ SCOPE OF ALL WORK BEING DONE 9~~~.~~~'~~ ~{~--7~~R rS~ ~
a~
VALUE (Including labor and materials) $ ~ ~~LI~J ~~-~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~~o~
City of Oshkosh
Division of Inspection Services
22i Church Avenue
PO Box 1234
O"""€-'-'- Oshkosh W7 54903-1230
Office 920-23b-5650
oNiH wntER Fax 420-23b-SOR4
Electric Installation Verification
{Electrical Contractor Name)
(Address) (City) (State) (Zip Code}
have been. contracted to perform electric installation v~~ark far ~~~-i'~~_/LC,I~-~~7't, l'-f-gam ,
{Name of party contracted to)
at the following address: __ ~ ~ ~ ~ ~ ~~°-~~ ~ ~
(Address where work will be performed)
The nature of the work consists af: {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 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 «=i11 require a separate permit. •f'
Reconnection ar new circuit far the replacement of other permanently wired
appliances I fixtures. _
Ne~v circuit far the addition of A,~C to an individual r~wellinb unit {house ar the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
Tlxe 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 df ~'.~ompany Officer) (Print lv~ame of Officer) (Date}
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