HomeMy WebLinkAbout0134221-HVAC (furnace)/~'~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 816 OAK ST Owner CHARLES DAKE ETAL
No 134221
Create Date 12/01/2008
Contractor WESLEY HEATING & COOLING INC 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 Applipble Value
BTU Rate As Per Plan Variable ~ Other Value 70,000
Use/Nature
of Work
/ REPLACE FURNACE,
Fees: Valuation $2,433.62 Plan Approval $0.00 .Permit Fee Paid $47.50
Issued By: U t t Id'' Date 12/01/2008
^ Permit Voided ~
Parcelld # 1105400000
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 54801 -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 oi' Oshkosh RECEIVE D
Division of Inspection Services
P.O. Box 1130 DEC 01 2008
Oshkosh, WI 54903-1130
Phone (920) 236-5050 DEPARTMENT OF
Fax (920) 236-5084 COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
HVAC PERMIT APPLICATIt7N'
All information after bold categories must be provided.
' Inicomplete 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-] 128. 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 narticinatinQ in the Permit fee Account Svstem and have adequate 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) 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 retained for completion.
DATE `~ - ~~,~ C~
JOB ADDRESS~~,~ Q -(~~lti_~ ~~- ,
OWNER loQr`C~~ Q d 1~ ~ ~J~~
CHECK 0 ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^Multi-Family
FUEL Gas ^Electric ^Solid
^ it ^Solar
^ Rental
SYSTEM
^Commercial
^New
^Other
^Industrial
[Replace
TYPE
)Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ^No Yes - LINER SIZEs~Ltl~ & MANUFAC"1"URER
Note: All chimneys shall be sized per the BT 's being vented.
CHIMNEY TYPE ^Cl7imney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable [Other Value ~(~ , ~ti~
DESCRIPTION /SCOPE t)F ALL WORK BEING DONE ~_~,`~-~~
-r --~-
VALUE (Including labor and materials) $ ~~~3. L~ =~
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) _~~3~~=~ ~ ~,~~,~~~~ ,
o~/o~
•... ~~ - ,.. ..,., , „~..~•,.~,ca~c~ nr~-+i lrtu l5L'r7) 2:35-f3951 f0~236T(~S
aPlapoaionsaaas
zrs au~xn.~
ao a~ ~ ia-
~~~~ t~liaMh wr sa~o3a ~3a ,
oro"~zo~i~u.~
Electrle Inst~I~uihinn 'V~lri~catia,s
..,~
(Elaatrica! Co~ntractar Natt:o ar owner's Name)
{Addn~ss) tChX~ Cam) t"Zig Code}
accept the tt'aponsibillty to perform the electric wnrlc as stated below, at the followicag address;
(Address where w~ock vvl~t be perforn>e~
'X'ha nature afthe work cOngiBts of: (Chcdr One o~c Descn'6c the Natuxe of Work)
.~ Recoynne+ctivn or new circuit far roplecxm+ent Heating Ft#nt sntVor A!C Corideaser:
~_ R~eccanctection or new Circuit far reptacem~ent Elc+ctric Water Heater or power vented
water heater.
~_ Reconnection of the Serv'ece Entrance Cable, Meter alterations to CeceptaCies
and Lighting #ixcunes due to siding / soi>fit instaltatian, Nate: Now Service
Entrance Cables will require s separate perttiit`
_. 1Zeconr-eetion or new circuit for the teplaieemer~t of attyer pErntartetatly wired
appliances l ~xtares,
_,_,_ New circuit for theaddition ofA/C to cry irtaiividua~ dy~elling unit, tincluding
twined service electrical outieb. ,Noi'e. I~omevwrrers can only do their tnm
electric an d srrtgle fartrily oivrer ocx~ied frome. Work otr o cpndnmfrrium,
drtpGPx, rertol, or nnrltl building wtsuldrequlre a licenxed .Electrical
~an<roctbr.
Other
'T'Fyc value of this work is ~ '/.~~`"
.t hereby vcri#'y this 'work will be performed in compliance with stye License requiretttenrts of
Section 1122 pf the Qshlcosh 11~(unicipal code atad fu~cr verity the reconnection / installation
will ~ done in eorrrpliance with martufacr„rcx and Electt7c code roquirements.
(8igneque tbmp~ny Offiicer ar Hoeliepvyreer} "{prjnt iJa,21e~ {Dato)
P.2
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