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HomeMy WebLinkAbout0139996-HVAC (furnace) Ci) CITY OF OSHKOSH No 139996 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 290 GREENFIELD TRL Owner GARY A FREDRICK Create Date 03/09/2010 Contractor AMERICAN HEATING & A C CO Category 500 - Residential- Heating & Ventilating Plan Fuel ✓ Gas U Oil Electric I I Solar U Solid System n New I n Replace [] Other u Forced Air u Radiant LJ Steam LI NC HI Vent Electric I I Hot Water Li Suppl. Con. Burner Chimney Type 10 Chimney A 0 ) Chimney B • Direct Vent 0 Not Applicable Heat Loss K) As Approved () Existing • Not Applicable Value BTU Rate 3 As Per Plan ( ) Variable 0 Other Value 80,000 Use /Nature SFR / REPLACE FURNACE, EIV SIGNED BY SECKAR ELECTRIC * *check #12741 of Work Fees: Valuati_ o n 1 I $4,000.00 Plan Approval $0.00 Permit Fee Paid $70.00 Issued By: Date 03/09/2010 0 Permit Voided Parcel Id # 0618170000 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 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number 235 -8090 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 R E jo rr A „ Division of Inspection Service D P.O. Box 1130 MAR 9 2010 Oshkosh, WI 54903-1130 Phone (920) 236 -5050 DEPARTMENT OF + 1 Fax (920) 236 COMMUNITY DEVELOPMENT • lir INSPECTION SERVICES DIVISION ON TNF WATER HVAC PERMIT APPLICATION • All information after bold cegories must be provided. Incomplete applications will not he processed. • Application(s) and fee(s) can he brought to City hall, Room 205 or mailed to Inspection Services, PO Box :11,7,L 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 f ou ate' - z contracto articiPatirrg in the _ Pertnit ee Accor _.. S 1 steer and have adequate funds. check here — -- _. .. if rorr want this Proces.cerit/lr�, ugh ynrtr_accaunt 1 DATE �— t7 w .10I)ADDRESS 290 6 ;e , OWNER CONTRACTOR eRW �'rrs // CHECK H AI,I, APPLICABLE, 1 ►� E CATEGORY Single Family DDuplex DMulti- Family ❑Rental _ OCommerctal C7lndustrial FTIEI. C ias ❑Electric OSulid SYSTEM DNew DOH Molar Re DOther TYPE arced Air ORadiant OStcam ❑A /(' OVent ❑ Ilectric ❑l lot Water ❑Suppl.DCon. Burner IS CHIMNEY BEING LINED *o ❑Yes - LINER S17.I: & MANUFACTURER Note: All chimneys shall he sized per the RTI I's being vented. —� CHIMNEY TYPE DChimney A DChimney 13 irect Vent ['Other HEAT LOSS DAs Approved ❑Existing of Applicahle- BTU RATE DAs Per Plan ❑Variahle ►'t )then Value pga 7,Lv DESCRIPTION OF ALL WORK BEING DONE__ e , _ -- /,s mod, Xir a e_ • VALUE (Including labor and all materials including light fixtures) $ ' �2 EI ECTRI('A1, CONTRACTOR OR lidlectric Installation Verification form attaehed(If Replacement) kit-mica/ invtallarinn of new/replacement equipment shall be done by licensed contractors. t7 RECEIVED c hyof Division of Inspection Services 215 cc. Avenut MAR 9 2010 PO Boi 1130 Oshkosh WI 54903 -1130 DEPARTMENT OF aMI :. 011ke 920-2345-5050 �•�� Fix 920- 236 -5084 COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION Electric Installation Verification I (We) he 67 T o e coil/ PA -AN / (Electrical Contractor Name) '! ZO C©v teTIU/ Pc o/in/h e-ie. 4 eDA D, W I AJ IV EConl t/t✓ t i 6 4 t16( 0 (Address) (City) (State) (Zip Code) have been contracted to perform electric installation work for ,hh ° 1Lf fu (Name of party contracted to) at the following address: 90 r o -/ t/� � '- /� work will be p (Addres where w 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 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 (house or the individual systems in a duplex or condominium), including required service electrical outlets. Other The value of this work is $ 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. (Signal of Company Officer) (Print Name of Officer) (Date) 5/02