HomeMy WebLinkAbout0133817-HVAC (furnace)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 111 W 10TH AVE Owner DAVID M BURKE
^ Solid
Contractor MARK WEBER HEATING & COOLING IN Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric ^-Solar __!,
System ^ New ~ / Replace ~ ^ Other
/ Forced Air Radiant Steam A/C
Electric Hot Water ^ Suppl. Con. Burner_~
Chimney Type Chimney A ~ Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existin Not Applicable Value
BTU Rate As Per Plan Variable Other Value
UselNature
of Work
Vent
~FR /REPLACE FURNACE, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES LLC (Greg Davis) **debt acct
Fees: Valuation $2,000.00
Issued By:
Plan Approval
$0.00
No 133817
Create Date 11/05/2008
$40,00
Date 11 /05/2008
Permit Fee Paid
^ Permit Voided
Parcelld # 0302220000
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.
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.
C.~.IHKOlH
ON THE WATER
• 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 (E1~ 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 retarned for completion.
DATE ` (~' S rUg
JOB ADDRESS G u Y~ ~D ~ ~~
OWNER ~~- ~ ~~U i'1 ~-~
CONTRACTOR ~19)'I •i' lt~i~"CL-
CHECK H ALL APPLICABLE
USE CATEGORY
(~ingle Family Duplex ^Multi-Family ^Rental
FUEL ^Gas ^Electric ^Solid SYSTEM
^Oil ^Solar
^Commercial
^New
^Other
^Industrial
~eplace
TYPE
,P9Ferced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
^Chimney A ^Chimney B
^As Approved ^Existing
OAs Per Plan ^Variable
direct Vent ^Other
^Not Applicable
^Other Value
DESCRIPTION /
OF ALL WORK BEING DONE ~~L,E{~'!i~l/ri'- b ~ ~~-
VALUE (Including labor and materials) $ o7DDy•ou
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
Y;
07107
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
HK H Office 920-236-5050
ON THE WATER Fax 920-236-5084
Electric Installation Verification
I (We) ~~ ( `~ rC 1~n17~f1~1~' ,'~Sn ~~71 I/iCt~
(Electrical Contractor Name)
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for ~~ / ~~Z
(Name of party contracted to)
at the following address: ~~~ ~~ f 1S
(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 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 new circuit for the replacement of other permanently wired
appliances /fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ ~G~ d ~ G ~/
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.
(~ ~~ ~ G ~?~ ~~r~
(Signature of Company Officer) (Print Name of Officer)
/~ S` 6 ~
(Date)
5/02