HomeMy WebLinkAbout0139627-HVAC (furnace)0
CITY OF OSHKOSH
OSHKOSH
HVAC PERMIT
- APPLICATION AND RECORD
ON THE WATER
Job Address
1016 N LARK ST
Owner OSHKOSH HOUSING AUTHORITY
Contractor
MARTENS HEATING
& COOLING
Category 500 - Residential -Heating & Ventilating
Fuel
❑✓ Gas
❑ Oil
Electric ❑ Solar
System
❑ New
❑ Replace -- - j
❑✓ Forced Air
❑ Radiant
❑ Steam ❑ A/C
Electric
❑ Hot Water
� ❑ Suppl. ❑Con. Burner
Chimney Type
Chimney A
Chimney B —
Q Direct Vent _ f Not Applicable
Heat Loss
(D--As Approved
0_ Existing
— — i Not Applicable Value
BTU Rate
� As Per Plan
Variable-------
Other Value
Use/Nature
FR / replace furnace.
EIV signed by Ace Electrical Services "debit acct
of Work
Fees: Valuation $2,046.00 Plan Approval $0.00 Permit Fee Paid
Issued By: J&
❑ Permit Voided
No 139627
Create Date 01/29/2010
Plan
Solid
Other
[Went
$41.50
Date 01/29/2,010
Parcel Id # 1601920000
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 _
Address PO BOX 514
Agent/Owner
OMRO WI 54963 -514 Telephone Number 920-685-0111
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 Oshkosb
Division o.f.'111-
,,,pection Services
P.O. Box 1130
Osbk
Pbo
Fax.
JAN 29 2010 HVAC PERMIT APPLICATION
Y
1p%! NT All information after bold categories must be provided.
0,4 �
C01r,"! Inconpletc applications will not be processed.
INS P"
Application(s) and fee(s) can be brouglif to City tTall, Room 205 or mailed to Inspection Services, PO Box 1128,
0sj-&osj, W1 54903-1128. Commencing work without pelmit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, whicb ever is greater,
(o JOB ADDRESSlol—k--bi,-_ V-�rV.r �,- - __
CONTRACTO
—7
CHECK 0 ALL APPLICABLE
�USF CATEGORY 0multi-Family EIRental 'S- i ngle Family ODuplex
F_,FL ,a 03lectric OSolid
SYSTE
oil M
ElSolar
DATE
ElCommercial [!Industrial
ONew
00tber
)�Replace
TYPE Suppl.,OCon. Burner
y-,Forced Air EIRadiant, OSteam EIA/C E)venj� DElectric Mot Water 0
IS CHI I MNEY BEING LINED ,to OYes - LINER SIZE-----.-- & MANIJFACTURER---
t
Note: All chinmeys shall be sized pe t e B'TU laeiaag vented.
CHIMNEY TYPE
HEAT LOSS
RTU RATE
ElChimney A. 00-timney B
CIA,; Approved DEXisting
CFAs Per Plain ElVariable
DESCRIPTION OF ALL WORK BEING DONVt--------
DDirect Vent
' Applicable
tber Value,—
*ther
y 6- 610
VALUE (Including labor and all materials including ligh t fixt'Ares) �k
ELECTRICAL CONTRACTOR
0— Fiectric installation Verifiestion form attached(If Replacement)
Ej,,- is I installation of crew/replacement equipnientghall he done tly licensed CoilfraMor
City orOshkosh
arlt,sp=aora s
215 pltach Avenue
PO BOX 1130
OV(� �u 0shk0M W154902-1130
7H— E' " w-- n Qfce920-2364050
Fax 920-236-5084
Eleetric I>asta of Verimad"
(1) (We) Y Q ✓'%f n F
(Electrical C for Name)
5
'C—X ICt-S LL
(Address) r o L�
(City) (State) (Zip Code)
have been contracted to perform electric inSWlation work for a
�
(Name of contract ) ,
at the following address:
The nature of the work consists of
(Address where work will be performed)
(Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Pl= and/or A/C Condenser.
Reconnection or new circuit for
Recarrknect�n of the Service Entrance
Electric Water.Neater.
ntrance Cable, Meter Box, alter to receptacles and
lighting fixtures due to siding / soffit ins# atiom 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 s
I hereby verify this work will be
reconnection /installation will be don ormed�pli lo of this co . an
mP 3' and further verify the
requirements. mauufactttrer and Electric code
(Signature of mpany Officer)
(Print Name of Officer) (Date)!