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Home My WebLink About0139217-HVAC (furnace)0 CITY OF OSHKOSH No 139217 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1806 DOEMEL ST Owner JOHN S ZARBANO /MERLAINE A ANGWAL Create Date 1210912009 Contractor Fuel System Chimney Type Heat Loss BTU Rate Use /Nature ' of Work DRUCKS PLUMBING & HEATING CO IN( Category 500 - Residential- Heating & Ventilating Plan ✓ Gas Oil J Electric Solar Solid ❑ New ✓ Replace ❑ Other ✓ Forced Air Radiant Steam A/C ❑—Vent Electric Hot Water LSuppl. Con. Burner ❑Chimney A Chimney B Direct Vent Not Applicable As Approved a Existing Not Applicable Value As Per Plan Variable Other Value / Replace furnace. EIV signed by Drucks Electric. Fees: Valuation $3,600.00 Plan Approval $0.00 Permit Fee Paid $64.00 Issued By: axy Date 12/09/2009 ❑ Permit Voided Parcel Id # 1514810200 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 Address P 0 BOX 355 Date Agent/Owner MENASHA WI 54952 - 355 Telephone Number 920 -426 -2654 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 Di -,'- ;on of Inspection Services P. ox 1130 Oshxosh, 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. • 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 area contractor participating in the Permit fee Account System and have adequate funds, check here if you want. this processed through your account F� ** 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. JOB ADDRESS �G %' _��'�' ->'�� I -5 OWNER t�l 2_ct, �O -!LL �? CONTRACTOR P ._ Z - CHECK M ALL APPLICABLE. USE CATEGORY Fsingle Family ODuplex ❑Multi - Family ❑Rental FUEL �as ❑Electric -OSolid SYSTEM ❑Oil ❑Solar DATE DEC 0 9 2009 p� DEPARTMENT OF COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION ❑ Commercial ❑New ❑ Other ❑Industrial replace TYPE Forced Air ❑Radiant ❑Steam ❑A /C ❑Vent ❑Electric ❑Hot Water OSuppl. ❑Con. Burner IS CHIMNEY BEING LINED I No ❑Yes, - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE HEAT LOSS BTU RATE DESCRIPTION / S Chimney A s Approved As Per Plan WORK BEING DONE kofdW ❑Chimney B Direct Vent ❑Other ❑Existing ONot Applicable ❑Variable ❑Other Value ?PE OF ALL 0 VALUE (Including labor and materials) $ J ��7 V. ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) .� c o7/o7 City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh W154902 -1130 0-f HP H Office 920 - 236 -5050 ON THE WATER Fax 920 - 236 -5084 (I) (We) Electric Installation Verification L' L- (El Name) (Address) (City) (State) (Zip Code) have been contracted to perform electric installation work for �� h V1 2 q r !2/Z r , (Name of party contracted to) at the following address: /iCl 6, L-:c-' e I,: t C- / l �. �' i ll «flr� (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. 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 other permanently wired appliances / fixtures. Other The value of this work is $ 'CT-:' • ei% I hereby verify this work will be performed by an employee of this company and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. 41A 7- iU4&At,(— t Me (Signature � (Signature of Company Officer) (Print Name of Officer) (Date)