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Home My WebLink About0133878-HVAC (furnace)OSHKOSH ON THE WATER Job Address 1706 LIBERTY ST CITY OF OSHKOSH HVAC PERMIT -APPLICATION AND RECORD Owner LISA C GOETSCH/CHARITY S CHANDLEF No 133878 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 Install 3" chimney liner. EIV ic. , Fees: Valuation $4,134.00 Plan Approval $0.00 Permit Fee Paid $73.00 Issued By: ~iC/rn~ Date 11/06/2008 ^ Permit Voided ~ Parcel Id # 1207740000 In the performance of this work, I agree to pertomt 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 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 O~HKOfH CAN THE WATER HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. 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. ORe ** Advisory -For applicable projects, an Electrical Installation Verification (EIVJ 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. JOB ADDRESS L ~~QCX CONTRACTOR CHECK Lf ALL APPLICABLE USE CATEGORY ~ingle Family ^Duplex ^Multi-Family FUEL ,bias ^Electric ^Solid ^Oil ^Solar DATE/~r°~~~~ ^Rental ^Commercial SYSTEM ^New ^Other ^Industrial d'~1Replace ~PE Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner ~/ IS CHIMNEY BEING LINED ^No~Yes -LINER SIZE~_ & MANUFACTURE f r~- ~ ' ~ Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ^Chimney A ^Chimney B Direct Vent OOther HEAT LOSS ^As Approved ~xisting ^Not Applicable BTU RATE ^As Per Plan ^Variable ^Other Value ~/~ v DESCRIPTION /SCOPE OF ALL WORK BEING DONE~~ LSD"`-'~'?~' ~~/J ~~e ;VALUE (Including labor and materials) $ ~~~ ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ~ ~ ~ o~~o~ City of Oshkosh Division of Inspection Services 215 Charch Avenue PO Box 1130 Oshkosh WI 54903-1130 Oll;co 920-236-5050 Fax 920-236-5084 Electric Installation Verification (Electrical Contra~cto/r Name or Homeowner's Name) /1/~? I du-~ ter`` /~y1 ~~c~c.~cwt~ 1~~ -s'~(/3~ (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: '1 U b ~~ber"~~~ _S~ 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, 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. ~- ~ ~~~~ ~ ~ O~ ~ (Signature Company Officer or Homeowner (Print Name) (Date) o~io~