HomeMy WebLinkAbout0133780-HVAC (furnace) CITY OF OSHKOSH No 133780
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 609 W 9TH AVE Owner JENNIFER L LISKA Create Date 11/03/2008
Contractor D R KOHLMAN INC Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System ~ New ~ ~/ Replace ~ ~ 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 ~ot Applicable Value
BTU Rate
As Per Plan
Variable _ _ ---_ -
__ i Other _ _ Value
se/Nature FR /Replace furnace. EIV signed by Helmer Electric
of Work
Fees: Valuation $4,309.00 Plan Approval $0.00 Permit Fee Paid $76.00
Issued By: Date 11/03/2008
Permit Voided
Parcel Id # 1303350000
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 117 CHURCH ST P.O.BOX 76 _ ST CLOUD __ _ WI 53079 - 76 Telephone Number 920-999-4631
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.
f~"a r. E. 2G05 i0:4~n!41 ~nspect:or ;ervic?~ ~~16 p.
No. ,
Ciry of Oshkosh
Division of lnspeerion Services
P.O. Box l I30
4shkostt WJ S4g03-2I3Q
Phone (420) 23b-3030
Fax {920) 236-508
HVaG PERMtT APPLiCATlON
All infom~ation after bold categories must be provided.
Incomptetc applications will not De processed.
• Applicatioe(s}and fee(s) can be brought tc City Hatl, Room 205 a mailod to Inspcction Services, PO Bax I 1 Z8,
Oshkosh WI 54903-1128. Commencing work without permit(s) will res,rlt in fees being doubled or 5100.00 pleu the
. normal permit fte, which ever is greater.
UR
DATE O ~ 8
D Cvtntnorcial O tndustri al
FTJ)lrL Gas OEleetrie OSolid SYSTEM ONew OReplaee
Oil OSolar OOther
E
Forced Air DRadiant Steam pA/C OVent Dlrlcetric C7Hot Water OSuppl. l~Con. Burner
CHIl~Ilr'LY BEtti'G LINED ~Jo C]Yes - LINER SIZE & MAN'UFAC'TURER
Itiote: All c'~imneys s}u1I be -sized pcT B1V's being vented.
ClitMl~~Y TYIR'E QChirnney A C7Chimney B ~ir+ect Vent ClOther
HEAT LOSS - Appravcd DExistung of Applicable
BTU ~-TE ^As Pa: Plan- OVanable Cher Value ~~~ (~
DESCRIl;''I70N OF ALL 1'~'ORK BEING
YALL~E .. ,S ~ C~ . t~~
I~L>~cTIUCAL colvTRAeraR ~ ',~ .~ ~ ~~~
For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attachada~r rtot applicable, a separate Electrical Permit is required.
OCT 2 8 2008
yio~
CHECK (~ ALL APPLICABLE
U E CATEGORY
Single Family ODnpiex OMulti-Family DRental
10/29/2008 13:54 920-999-2602 D R KCaiMAty 1NC~
apt, 29. 2aoB 2:aoP~
coy aramma
o~aro,ort~h.aiuaa~
]t7 CbuehA~
PO bx Ili
O~hlem WI S19D3-tia0
Olga y20.~'Jb3030
F1x q~.~6.s0IIa
I (Wc)
(Address)
'flee nature of the work consists oF. (Check One or Describe the Naturc of Work)
(~~ ~~
Recomection or »aw circuit fox rcplaconoent ><Teating Pleat and/or AJC Condenser.
Racornaectioq or r-ew circuit fox raplareraertt Eltctcic 1iVater Heater or power vented
water heater.
Reconnection of the Servleo Eatrancs Ctibte, Mater Box, alteradons to receptacles
and lighting fixtures due to siding / sort iastallation. Note: New Service
$ntrancx Cables'will require a se~u'otc permit,
Rewnneatioa or new circuit fox the replacement of otbor permauentty wired
mpplianaes !fixtures.
New circuit for the addition of A/C bo an individual dwelling unit, including
required service electrical outlets. NoM: 1 Y'omeowners can only do their own
electric o» a single family owner occupied home. 6~ork on a condominium,
duplex, rental. or multi-use building woxld require a lteenaed Fdectrka!
Contractor.
~, Other
1'he value of this work is $ ~,.~ 7
I hereby verify this tiwtlc will be perfvrnted incompliance with the License regniTemerats of
Section 1 t-22 of the Oshkosh lViunicipal code and fiulber verify the recoto~cction / isu~llatiou
will be done In compiiaoce with manufacturer and Elecrric code requiromcnts,
T~ectric Installation Ve~fcation
rant e~int
No, X556 P. 1
(Eleatrieel Cou~cactorNa>rie or Homeowner's Nstne)
Otliccr or Hom~owacr)
~~ p P,~trnr ~
(t'rhtNstne) (~e)
Oy107
~ ' d fr80S9~Z@Z6 ti ~ 01 6L£6906026 ~ I ~11~313 ~13~-I~H = t-~21~ k1S€ = 60 8002- S ~-
accept the responsibillty to pcrfOtm the electric work as stated belov~r, at the fallowing adQress: