HomeMy WebLinkAbout0134118-HVC (furnace)OSHKOSH
ON THE WATER
Job Address 505 507 HlJBBS AVE
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner STEVE R/TINA M STENBERG
Contractor D & S HEATING AND COOLING Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System ~ New ~ 0 Replace ~ ~ Other
/ Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimne A Chimne 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
Fees: Val
Issued By:
Plan Approval $0.00 Permit Fee Paid $41.50
Date 11 /19/2008
Permit Voided
No 134118
Create Date 11/19/2008
Parcelld # 1209400000
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 cure any s~PProv s before~art~np such activity.
Signature ___.~ /~~~~~~
Date
Address W1418 TOWN HALL DR
Agent/Owner
PULASKI
WI 54162 -7517 Telephone Number (920) 660-0097
To schedule inspections please call the Inspection Request line at 2311-5128 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.
E FURNACE,
R ELECTRIC LLC
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.
O1HK0 H_
ON THE WATFR
• 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 System and have adequate funds, check here
if you want this processed through your account n
** 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 ~~'l / ~ ~~
JOB ADDRESS ~ ~~ a~~~ ~U~
e v~
CONTRACTOR ~ .D`}S ~ akin ~ a,(~ oc~,l n ~,
CHECK Q ALL APPLICABLE
USE CATEGORY
^Single Family Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ~ias ^Electric ^Solid SYSTEM ^New Replace
^Oil ^Solar ^Other
T}jPE
Forced Air ^Radiant ^Steam OA/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED,.~iNo ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ~himney A ^Chimney B
HEAT LOSS ^As Approved ^Existing
BTU RATE ^As Per Plan OVariable
D SCRIPTION /SCOPE OF ALL WORK BEIN-G/IIf(
^Direct Vent OOther
~Ot Applicable
^Other Value
1E ~~~ ~-c ~~~~ ~ s ~O G
m~~
VALUE (Including labor and materials) $ ~ ~ ~ ~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~/o~
City of Oshkosh
Division of Inspection Services
21S Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
HK H Office 920-236-SOSO
ON THE WATER Fax 920-236-5084
Electric Installation Verification
I (We) ~ av~ ~ ~e~`t~ t'` L ~- ~
(Electrical Contractor Name or Homeowner's Name)
~7)
C.i2 _SLj /~~
(Address)
(City)
(State) (Zip Code)
accept theCresponsibility to~lperform th/fe electric work as stated below, at the following address:
J ~~ ~~ O ~ ~ S /'~ !ice ~SCi /~'d.rG~
(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, 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 $ '~S
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 incompliance with manufacturer and Electric code requirements.
11-~g~ag
(Signature of ompany Officer or Homeowner) ~ (Pri Name) (Date)
07/07