HomeMy WebLinkAbout0133851-HVAC (furnace & a/c)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1629 W 9TH AVE Owner RICHARD C BOESE
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature
of Work
No 133851
Create Date 11/06/2008
DRUCKS PLUMBING & HEATING CO IN( Category 502 -Residential-Both Plan
/ Gas Oil
~.- - _- Electric Solar Solid
New I ^/ Replace J Other _
/ Forced Air p ,Radian Steam / A/C Vent
Electric ----
~ Hot Water
Suppl.
Con. Burner
Chimney A _ _ --
Chimney B
Direct Vent
Not Applicable
As Approved Existing Not Applicable i Value
As Per Plan ~ Variable Other _ i Value
**check #62899
Fees: Valuation $8,900.00 Plan Approval $0.00 Permit Fee Paid
Issued By: ~~~ ~'
Permit Voided
$143.50
Date 11 /06/2008
Parcel Id # 1309370000
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
AgenUOwner
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.
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.
01HK~
ON THE ~N'ATFR
,+
NOV 0 6 2008
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspeat~Itlt~i~ye~~i¢ $c~~a•;~-~,~8,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fed~l6Pfiig tldtilflf;~d~C~~~9po- the
normal permit fee, which ever is greater.
OR
If you area contractor~articipating in the Permit fee Account System and have adequate funds, check here
you want this processed through your account ~]
** 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.
DATE je~-ZZ-~B
JOB ADDRESS ~ ~ 2~ ~~ JT
OWNER ~~cl~ ~dL Sc
CONTRACTOR ~~~s ~S ~ ~z
CHECK D ALL APPLICABLE.
USE CATEGORY
~lSingle Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
,;
FUEL ~[Y1.7aS OElectric !].Solid SYSTEM ^New J~'Replace
^Oil OSolar ^Other
TYPE .
forced Air ^Radiant ^Steam ~A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINEll Clio ^Yes, -LINER SIZE ~ ~ & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved ®'Existing ^Not Applicable
BTU RATE ^As Per Plan Variable ^Other Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE KL-~P~-e-t= ~~C-"~ ~9~J ~~c,
~qo®
VALUE (Including labor and materials) $
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ~ IIU.U~S
o~/o~
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54902-1130
O.f HKOIH Office 920-236-5050
ON THE WATER Pax 920-236-$084
Electric Installation Verification
(I) (We) ~IL~C-1~-5 i"cet.tM.6r•.~t~ a- l`~r'/~!-~7~Jy r- C-'2-~z-?YL-~ ~
(Electrical Contractor Name)
f y Cr~~ Si ~r?~y ~ ~ S'~`~/9 S'Z
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for ~e t~5 ~~~~-ucs ,
(Name of party contracted to)
at the following address: ~ ~ 29 ~ ~ ST
(Address where work will be performed)
The nature of the work consists of : (Check One or Describe the Nature of Work)
A( 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 $ 2S~ ~
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)
~~' ~~%~~~2-~/2-Z(. ~U ZZ (~$
(Print Name of Officer) ( ate)