HomeMy WebLinkAbout0134250-HVAC (furnace)/~'~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1315 MORGAN AVE Owner STEVEN R HABERKORN
Contractor
Fuel
System WESLEY HEATING & COOLING INC
/ Gas ~ Oil
^ New i
/ Forced Air Radiant
Electric Hot Water Category 500 -Residential-Heating & Ventilating
^ Electrc _ ] ^ Solar I
/^_Replace _
team ~ ^ A/C
Suppl. ~ ^_Con_Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existin Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature
of Work
No 134250
Create Date 12!03/2008
Plan
^ Solid
^ Other
^ Vent
70,000
/REPLACE FURNACE, EIV SIGNED BY
Fees: Valuation $3,394.00 Plan Approval $0.00 Permit Fee Paid $61.00
Issued By: ~-~- Date 12/03/2008
^ Permit Voided Parcel Id # 1226630000
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.
~.~,:~~ ~ t~s.cA
('ity of (lshl.osl-, %'~ -~
Division of lnsp~~Ii~~n Servic-c-s ~ ~ ~ ~ ~~
I'.O. Boy, . 1;0 ,a ~~
t )shkosh. ~VI S49i1 ~-1 130 f, ~~~~__\ ,_~
L i= i. ~ t~ - - -
i'hbne (920) ? ~G-`(i>0~ 'V ' ~ ~' I_ .•
~ ;,. (920) 236-~u~a DEPARTMENT 0~~~ ' ~'~~~~ ~'
COMMUNITY DEVELOPMENT
H~~C ~E~t~~IT ~F`PL~~~CI~AI SERVICES DIVISION
All informalion after bold cate~uric~ nnis+. be pr~~•~4d::d.
Incomplen ap~~li~ations tiv~iU noi't~~c pruc~sscd
~ Application(s) and fee(s) can be brought to City HaIL Room 0:i or nailed to f nspection Services, i'O 130 1 1 ~~.
Oshkosh WI 54903-I I28. Commencing ~~~ork witi~uut permit(ti) ~~~ill result in i~ees being doubicd or `;~ 100.Q(~ i~~u~; ;hr
normal permit fee, which ever is greater.
If you are a co~~a c~or partieipali~a~ in the i'ern,}~~~eE .9ccnu~ _5'1~.>lrn~ any! have adegii~rr~_~i~n~i.~_ ~~h~ ,_(~~ r~
i{ you want this~rocessed through your nccou~al
** Advisory -For applicable projects, an Electrical InstaIlation Verification (EN) forni, signed by the I3lcctrical
Contractor or Homeowner (for installarions ~Ilowed to be pcrfortned 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 ~~ - ~~- O°-~ _
JOBADDRESS_ ~~~j ~nt2C_a(aa~_ ~~[~__---
OWNER ~~1=~1 t= .~'~~_~~'--~~-- ----
CONTItACT()R\ x~=`~~. ~-Z~ ~-~ .4~~.1ht,~_~ ~~~~.~~_~l
CHECK E'(A[,L APPLICABLE
~E G~TEG(}RY
Single Family ^Duplex ^Multi-Farnil~ L_1R~~nt,li ^C~~nunercial C~in,lu~~rr~~
FUEL C~Gas ^Electric ^Solid 5~~"1~I:'~~I ^i~c~a~ ~Rc~,~l~~c~~~
^Oil ^Solar ^(~t;~er_____
"I'YPI?
~orc,d Air ^Radiant ^Steani ^AiC ^~~..„t ^1-.'~,ectr:~c ^11~~t \~V~ater ^Supp; ~~i ~~~~. !3ii~~~e"
IS CH ,'~'INE1 BEING LINED ~No ^Ye~ - l INi I-', S17'~: _ ~ ~~11~Ul~AC~~URFR_ _ ___ __
Nate: ~ ii chime c~> shall he sized per the BTL"s ht~,~~~ ~~ ~.~~_i.
CHIi~ :AF,~' ~I YPI; ^Chimne}' ,~ `~_`„ :" f 3 ~,i)~ ~: `•.~n! ~Oti~er
III;A"1 [ OS5 ^As Approved ~3 ~.i~~ ~ ~.~ ~'~~ ~ ~ ~,~ i~ ~"~~
E3Tli I .~'CE ^As Per PI<:n ~ . _.r~ . [~`-~.~~ ~ ~' ._ ~ ~~:~~ - _
t) E
~'ALf
F:t:E(
KlP"Cl(~-~ ' tiCOPE OF ALI. ~VOI i.; I;i•:i~r ~ ;1C?\h: ~ "~-;_ ~~'~=-- ~--~--'~=-~-'=' ~~-- -
~;~ ~ ~~.
E~. (fnclndin~~ lahar and materi~ils) ~_ ,~,__~ ~ ~ u..~,~____
L ;
I~RIC II- (~OAff~_~CTOR (for projects n~~t re~~u;i in~~ an F:lV~ i nrni; ~~;~_~~~--~.',~ c~~ ?~~~-~=,:
c~ ~~
1 ~ h ~~ ~,
~:1~cI-e\~j~~'
~ }.~
` Os6 Rt ~
(cal -r r. - ....
~
~"'
~'S~- ~- w-;!?"L~-~ Fns . _.,,- _ , .
~e:~~~c ~~s~a~I~~ion ~~rificab~or~
z ~~~~} u - a ~ ~~ ~~~ R ~
` ;;-?Ic,:trical ~o~~tractar Name or ~OrntOwztcir's Name)
{Address) -~! (City {State) (Zip Cade}
accept the eespartsibii ity to }~r('arm the eiectric worE~ as stated t~elovv, at the fotiowin~ address:
:~
(Address where work wit! bepetfornted}
The ststttre bf tiie work consists v~ (Check fine or Describe the i`Tature Q~ Work)
~_ Recartnectian ar- new circuit far replacement Rcatir,g ~'lant and/or A/C Gonder~ser.
Reoanraect~iorr or new circuit for rep]~emestt l:le+ctric Water Heater ar power vented
waccr heater'.
}Zeeorlttectivn of the Service ~ntranee Cabe, ~Ct~r$p7C, ~(t~'dtibl~°~ t0 rCeeptBeles
and ii~~'-~iii~g Fr;tures d~.fetc, skiing/S4~ltinstalf3ti0n. IVt}LC: N8W Service
1/.~tr;,;::r•: ; ,<;blc:~ ~~~iii r~_~i;ire ;. separaze permit:
r2e~.otn.:ctic,~, or r,cw circut for the replacement ofothcr permanently wired
Ne<,a circuit ;"or t~E add~ion of AIC, to an indivicl`ual dw~l~i~~zg unit, i~efuding
rec{nired scr-,-ice clcctrii;al ciut(ckti. Note: Hom2t?wners Cc7n only do their own
elec?~-ic ~%ts ~ si.>r~l~ f~ntily otvr:er occry~ied hums. Work oft a cdndominirmr,
du~lcx, r~.~tal, c?r multi-use b2~rlding t+'au/d Pequire ~ licerrs~d Llectriecrl
C~~~tt~-~r,'na-
Ot11cr
'The value ~f rhi.: w<,F~K ; ~ ; Ca
`' ~``~ °"~~`~'-r '~~ ~' "?i t~ ~r,~c~ :~ :<~rrtpfian v with the License re~~uirc~.l~nts o~
t' •, : 1 ~
-_ ~ r~~ ;~,, a ~ ;;~~~ ~,, turti:::r verify the recc~raecti~e inst~llstion
'i ~° u7~ C !~ ~C~" i n ~
~a~~ua . ~.:,[ur r ~,, Glecr ~~ code requirerr~ents.
i
~;„ ~ tP~;u Neme) Date}
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