HomeMy WebLinkAbout0139887-HVAC (furnace) C D CITY OF OSHKOSH No 139887
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1124 ELMWOOD AVE Owner CHOICE PROPERTIES OSHKOSH LLC Create Date 02/26/2010
Contractor BETTER HOME HEATING & AIR CONDII Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas U Oil 1 Electric u Solar I Solid 1
System n New 1 n Replace 1 n Other
�J Forced Air Li Radiant Steam u NC ❑ Vent
U Electric u Hot Water U Suppl. Li Con. Burner
Chimney Type (D Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss ( ) As Approved () Existing • Not Applicable Value
BTU Rate () As Per Plan 0 Variable • Other Value 40,000
Use /Nature DUPLEX (LOWER UNIT) / REPLACE FURNACE, EIV SIGNED BY BUD'S ELECTRIC * *check #65366
of Work
Fees: Valuation $1,847.00 Plan Approval $0.00 Permit Fee Paid $38.50
Issued By: 3Yn Date 02/26/2010
❑ Permit Voided I Parcel Id # 0503260000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1054 AMERICAN DR NEENAH WI 54956 -1305 Telephone Number 920 - 733 -2161
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
RECEIVED
City of Oshkosh
Division of Inspection Services FEB 2 2 2010
p O. Box 1130
Oshkosh, WI 54903 -1130 DEPARTMENT OF
Phone (920) 236 -5050 COMMUNITY DEVELOPMENT � H��f H
Fax (920) 236 - 5084 INSPECTION SERVICES DIVISION r f r I
ON TNF WA1F
HVAC PERMIT APPLICATION
All information alter bold categories must be provided.
Incomplete applications will not be processed.
to Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh Wi 54903 -112$. 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 participating in the Permit J'ee Account System and have adequate funds, check here
if you want this processed throe &l your account n
** 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.
DATE - / 7-10
JOB ADDRES Ji 2 , .
OWNER ( � 1Iy1 J
CONTRACTOR -04
CHECK 0 ALL APPLICABLE,
USE ATEGORY
K I3uplex D Multi- Family Mental DCommercial Cllndustrial
FUEL Ei Xas DElectric DSolid SYSTEM DNew [Replace
DOil DSolar DOther
TYPE
DForced Air DRadiant DSteara DA/C DVent DElectric DHot Water DSuppl. OCon. Burner
1S CHIMNEY BEING LINED DNo DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE [Chimney A DChimney B DDirect Vent DOther
HEAT LOSS DAs Approved DExisting [Not Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DESCRIPTION / SCOPE O A WORK BEING DONE z 57Z'
- f �J�r1
(.IO U 1
VALUE (Including labor and materials) $
ELECTRIC A.I. CONTRACTOR (tor projects not requiring an ETV >Lorsss) *
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903 -1130
J/ -Kc f H Office 920 - 236 -5050
ON THE WATEa Fax 920- 236 -5084
Electric Installation Verification
I (We) `-'CA 1 5 S I-4L (2 LC 1 I
(Electrical Contractor Name or Homeowner's Name)
A - RO a 7a.- o Ot-1 1.--� 5 3
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric w rk as stated below, at the following address:
a
/ley PilatO .
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
X Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
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 the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi -use building would require a licensed Electrical
Contractor.
Other
4 1-----
The value of this work is $ /
I hereby verify this work will be performed in compliance with the License requirements of
Section 11 -22 of the Oshkosh Municipal code and further verify the reconnection / installation
will be done in compliance with manufacturer and Electric code requirements.
.1/ .- = Z e 1 & s z� I b ..1
:..�� z
S _ � o om an Offi cer or Homeowner) (Print Name
( P Y ) ( Name) (Date)
07/07