HomeMy WebLinkAbout0134251-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address 1214 GRAND ST
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner PAMELA R MILLER
No 134251
Create Date 12/03/2008
Contractor WESLEY HEATING & COOLING INC Category 500 -Residential-Heating & Ventilatin Plan
Fuel / Gas Oil Electric Solar Solid
~- ---I ~__- _ ~
System ^ New ; /~Replace ~ ^ Other
__
Forced Air
Radiant --
~-Steam ~
^_ A/C ', ^ Vent
Electric / Hot Water [~ Suppl_ ~ ^ Con. Burner
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 FR /REPLACE BOILER, EIV SIGNED SOLAR ELECTRIC **check #95919 - - -
of Work ,
II
_.,
Fees: Valuation
Issued By:
Plan Approval $0.00
Permit Fee Paid $74.50
Date 12/03/2008
^ Permit Voided ~ Parcel Id # 1507210000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 3220 BASLER LN OSHKOSH-- WI 54901 -0 Telephone Number 920-235-6951
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshl~~asl;
Division of Inspection Services
P.O. Box [ 130
Oshkosh, W[ 54903-1 l30 ~ ~~
Phone (920) 236-5050
Pax (920)236-5084
DEC 0 3 200$'" r;:; "'~''`
HVA~ PERMIT APPLICATION EPARTMENT OF
All informatior, after bold categories must be p -ova i
Inco;replete applications will not be proces~~M NIIY DEVELOPMENT
INSPECTION SERVICES DIVISION
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Bos 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will renilt in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating i~?_th~ Permit. Tee Account Svstc~n~ anti have adectrEate funds, check here
if Vou leant 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 perfornied 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 ~~.\~- C1~i~5Jsc~, ~ ~,
~--
OWNER ~~n,» ~ ~ ~ ~ ~ ;
CONTRACTOR ~. '~ - -t- ~
~_ _
CHECK L ALL APPLICABLE
USE CATE;(:OKY
Single Family ^Duplex ^Multi-T~amily ^Rental
FUEL C~Gas ^Electric ^Solid SYSTEM.
^Oil ^Solar
TYPE
^Forced Air ^Radiant ^Steam ^A;C ^Vent ^Electric
^Commercial
^New
^Other
^Industrial
Replace
[~(~ot Vb'ater ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ^No ~Ql'es -LINER SI7.E~~~ 1~~ &. MAIyUFACTURER
Note: All chimneys shall be sized per the B~['t~~s being vented.
CHIMNEY' "TYPE ^Chimney A ^Chimney B Direct Vent ^Other
HEAT LOSS ^As Approved C~xisting ^Not ,~pplicahle
BTU RATE: ^As Per Plan ^Variable Other Vague __
DESCRtPTIr'~ /SCOPE OF ALL WO?Rr` BI<:ING DONE_~~,~~_~,~_ - .~~
~ G
VALUE (Including lahor and materials) $ ~~~~a , ~~j __
-l
ELECTRICAL CON'CR.ACTOR (for projects not requiring an EIV Form) _, ~ ~~ t.
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EIt~r4~lric ~ln~ta~~at>!on 'Ver~~c$~inn
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(8lectrira Cotmactvr Name or l~omeowwler's Name}
(~s.ddress} (Ci
ZY) (State} (Zip Cone}
e~pt the respansibifity to perform [he eiactric warp as stated below, at tfae faliawing address:
(Address whew work will be peeformed}
~"he nature of the work consists of: (check One pr Describe the Nature of Work}
..~,., Reoons~ection or new circuit far replacement Heating Ftant and/ar ~,IC condenser.
Reconnection or new circuit for replacemenrt Electric Water Heater or power vented
wathr heater,
l~ecor~ncction of the Service Pntranee Cable, hietcr $o~c, attcrations to rtceptacles
and lighting fixtures due ~ ssdsrtg ! soffit insrailation. Nate: New Service
Fntrancc Cables will requim a separate petxrtit.
RecanrCCtiot~ ar new cirtruit far the replacement of other pelYnanentty wised
appliances / fixtures.
?stew circuit far the addition afA/C to an individual dwelling unit, including
required service electrical outlats. Note• ,Firorneowyters can r~nly tin their own
electric on Q single family owner occryoted horrre. T~'ork on a Condo~rrintunt,
duplex, rerrtQl, or multi-use ~u€ldfng would requrr~ d licensed ,rr`lectrical
Ccrrrtrpctar
Other
~'he value of this wsxk ;~ ~_._~~_~ E`'-
] hereby verify ~~ i. ~vt~rlr will be pcrt"ormed in :r~rnAlianc~e with the Licet?:rA recruire~nents rtf
Section 11-22 of , ~~~izi:osh Munie.ipal sac's and iurttterverify the rea:~s~nect%al~,` i;lstaitat;c~z~
will be done in c r»r~iiance with manufacturer ;nd ~fectric cc}de requir~rr~:nts.
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