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Home My WebLink About0133879-HVC (furnace)CITY OF OSHKOSH No 133879 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 533 W 5TH AVE Owner BRIAN K SCHUETZ Create Date 11!06/2008 Contractor D & S HEATING AND COOLING 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. Bumer Chimney Type Chimney A Chimney B Direct Vent Not Applicable Heat Loss As Approved Existing Not Applicable Value BTU Rate As Per Plan Variable Other Value Use/Nature of Work / Replace ~'~. ;,< ~. Fees: Valuation $2,718.00 Plan Approval $0.00 Permit Fee Paid $52.00 Issued By: ~/jyjJp Date 11/06/2008 Permit Voided ~ Parcel Id #0600390000 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 starring such activity. Signature Date Agent/Owner Address W1418 TOWN HALL DR PULASKI WI 54162 -7517 Telephone Number (920) 660-0097 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. O.IHK01H 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 If you are a contractor participating in the Permit fee Account Svstem and have adequate funds check here if you want this processed through Your account n ** Advisory -For applicable projects, an Electrical Installation Verification (E1V) 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. /J DATE ~l/ ~Q' ~(l JOB ADDRESS ~~ ~ ~ ~~'~/ /~` (~ e- OWNER~tl ~'Jj cL ~~G~/(!~ ~~/"P~' CONTRACTOR-.~ 0~J ~7~ q~ ~,I mop ~1~ CHECK C~ ALL APPLICABLE USE CATEGORY ,,Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial FUEL ,Gas ^Electric ^Solid SYSTEM ^New Replace ^Oil ^Solar ^Other TYPE Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. OCon. Burner IS CHIMNEY BEING LINED~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 ^As Approved ^Existing Not Applicable~~~ BTU RATE ^As Per Plan ^Variable ^Other Vlalue ``// DES IPTION /SCOPE FALL WORK BEING DONE ~CA.~~. P~iS~i:n r ~/~' y C~' i z'/f1t/I C'' t c,~ 7`' ~~'n Gl/ ~ VALUE (Including labor and materials) ~~~ ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) bUd yGh~ ~/~'~/'/~(r o~~o~ City of Oshkosh Divisi~ of Impaction Sotvices 215 Church Avesta PO Box 1130 ~~ Oshkosh wl 54903-1130 Office 920-236-3050 Fax 920.236-5084 Electric Installation Verification (Electrical Contractor Name or Homeowner's Name) (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: S 3 3 ~/ ~~ ~ ~v~ , (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 AIC 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, including required service electrical outlets. Note: Homeowners can only do their own electric on a single family owner occupied home. Work on a condominium, duplex, rental, or multi-use building would require a licensed Electrical Contractor. Other The value of this work is $ ~ ~~ ~" I hereby verify this work will be performed in compliance with the License requirements of Section 11-22 of the Oshkosh Municipal code and further verify the reconnection /installation will be done in compliance with manufacturer and Electric code requirements. (Signature of C parry Officer or Homeowner) (P t Name) (Date) o7~m