HomeMy WebLinkAbout0133904-HVC (furnace)l~ CITY OF OSHKOSH No 133904
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2217 ASHLAND ST Owner DAWN M/DANNY K BREWER Create Date 11/10/2008
Contractor WESLEY HEATING & COOLING INC Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric _~ Solar Solid
System ~ New ~ ~/ Replace J ~ Other
/ Forced Air Radiant Steam _J 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
Rate
er Plan
Variable __
Other _~ Value
70,000
Use/Nature
of Work
Fees:
Issued By:
Plan Approval $0.00
Permit Voided
Permit Fee Paid $64.00
Date 11/10/2008
Parcel Id # 1516140000
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 3220 BASLER LN OSHKOSH WI 54901 -0 Telephone Number 920.235-6951
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 APPUC~TION
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor Darticinatine in the_Permit fee Account Svstem and have adeauate funds. check here
if you want this processed through your account
** Advisory -For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) mast be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
' DATE_ 1~- '`Z ~~
JOB ADDRESS~j~,`~ ~~r~
OWNER ~~ m e .-~ r
-- r
CONTRACTOR ~
__
CHECK 0 ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ~as ^Electric ^Solid SYSTEM ^New [Replace
^Oil ^Solar ^Other
TYPE
forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Bumer
IS CHIMNEY BEING LINED ~QNo ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per t}}~ie BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable 6~Other Value ~~ ~(~~
DESCRIPTIO`N /SCOPE OF ALL WORK BEING DONE
4~~ ~ ~ -,cam n Q
VALUE (Including labor and materials) ,$~~~~.~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) o~~~~,R~ -~~ ~~ ~~~
o~~o~
-- - - -- .. , ..,_.. , .,. .. _ r,cr, i ,~,nw ~y~~~ i.:;A 69;1 TCI: ~3577L'S
2i5 ~ac~ /~
1'at~ac tt3Q
O~ W[ sit9o9.1130
>~ ~~3t1-sAti
~i'~C ~ii~1t ~@2I~C~t101!
i[ (Wej
{13[ectrical ~ont~aGbor Name or ~otneowncr°a Nat>x}
~) (State} {'Zip Cadc)
$ ~ ~+~'~' ~- ~ rite al+aatric ~+rnic $~ stated below, at the i`+aTlaanng address:
(Acfdt~ss vvhcm w+odc will be perfornte~
'£he refit of tip wotlc'! c~mststs ai _ (Check One or Descn`be the lVat>.tre of worm
.~„ ~catu~ction oc new chrruit f°x repfacerne~ ,fig Plant xrndloe A!G Cam.
Rarontt~ction or new citcuir ;for ~~ ~ yu,~ ~#ca~r ar power r~cnttd
water heatex.
~i Rejection of the Ser+rice Es>~Ia>aEx C.abla, Box, alberttians to r~ptactes
arbd l~itt:ng ~'iaclunes due ter sidhtg / sort msbtttatiott, iYt~te: ~iCvv S+e~'vice
~ Gables will ~ ~ ~ Flit.
Reconnection tfr new eis~t for`the placement of other Permanently wised
appliettccs f i~t~.
New ctroaitfor the addition ofAlC to an rr~dividuat dwellr'ng u-rFt, inclada"ng
repaired service elecCrirxi autiets. ,Note: f~omern+mcrs can only ~ tJaerr ot~
e+tectr~c on a single family owner occupied hv~rre_ T3rr~rk crx~ a aaa
duplexy re>titrzl, or multit srse huildi~g trrarrdd r~egab~ac a !iced ~~1
~'vnlrncROr.
Other
Tl~e value of tttSs wcfrk is $ (~"~- `~'
I I{ereby this vvoric witi be perfornaed in ootnpllance with the License rettuiren~ts a£
3ec~gt } I -2~ of fire t~snkosh Municiptti code and ~urthe= verify tt~e reconne~ion ~ instaliatiot:
wil{ be dame in compliance with rnartufacturer and Electric code re~U,iremer~s.
,~
{S~~ oiF c?t~ioer or Homeaa„gr C'rt L: ~ ,cam` d~
trl>n Name {torte}
p. ~
87/07