HomeMy WebLinkAbout0140587-HVAC (furnace) el) CITY OF OSHKOSH No 140587
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 216 BALDWIN AVE Owner TERI L PARNELL Create Date 04/20/2010
Contractor ONE HOUR HEATING & AIR CONDITION Category 500 - Residential- Heating & Ventilating Plan
Fuel LJ✓ Gas Oil Li Electric 1 Solar Solid
System 0 New 1 n Replace ❑ Other I
u Forced Air L Radiant u Steam a A/C u Vent
L) Electric LJ Hot Water L Suppl. Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss K ) As Approved 0 Existing • Not Applicable Value
BTU Rate a As Per Plan 0 Variable • Other Value
Use /Nature SFR / REPLACE FURNACE, EIV SIGNED BY ACTION ELECTRIC * *check #5334
of Work
Fees: Valuation $3,800.00 Plan Approval $0.00 Permit Fee Paid $67.00
Issued By: Sbr-iyis_ Date 04/20/2010
0 Permit Voided Parcel Id # 1003360000
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 2100 FREEDOM RD LITTLE CHUTE WI 54140 -1231 Telephone Number 920 - 687 -9126
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
Division of Inspection Services 0014Aiir
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 �^'�
Fax (920) 236 -5084 Of- KO H
ON1,FWAFR
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account f
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion. /
DATE L i / I) 0
JOB ADDRESS 91 LQ rl; A (..,,j1+'1 PrLy fl (j •
OWNER — c) - 1) X &n 1 - RECEIVED
CONTRACTOR Mt n 1 C)►'1Q fk APR 19 2010
DEPARTMENT OF
CHECK H ALL APPLICABLE COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
USE CATEGORY
Wingle Family ❑Duplex ❑Multi Family ❑Rental ❑Commercial ❑Industrial
FUEL Mas ❑Electric ❑Solid SYSTEM ❑New l$ Replace
❑Oil ❑Solar ❑Other
TYPE
orced Air ❑Radiant ❑Steam DA/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED EiNo ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable _
BTU RATE DAs Per Plan ❑Variable ❑Other Value n n 70 / 6U0 8 / LL
ESCRIPTION / SCOPE OF ALL WORK BEING DONE 1aCk �1k(r'aP� (,t) ,+�
-„ rnri l?rer1; r - 74, . TCc 6Jc) 411a01/
VALUE (Including labor and materials) $ 3 go j , O (! PQ r,ti2`t'1" -2 e '. 1. t.0 - 7. 6
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) I`f b l
di ec7 f i -
07/07
•
•
OiiFrnsTwi: fo.sctt
713fateridiinte
R3 Rua MO
alkh w St Cr•cOi
Rat rnaalsl.w
O - fir 911616401K
°° Electric Installation Verlficaiion
I (We), Act a') E`E iC l -e ectrica1 Corl'rrac orS 1 nc.
(Per dcal Contactor Narne or Hnmeawner'cNone)
\t1 PICin ato Ty_ TS 1. a.i_Ave u1 X t 1 SS41
(Address) (City) (Stela) (Zip Code)
accept the responsibility to perfcrns *heelxltic nark bs abated blow, at Ht, following address!
Qw1/4)
•
(Addres cwkaa mark will bo pedroracd)
Tito nature of ens mod( consists of: (Check One or Describe the Neter: of iVork)
Ro oniswtion or new oirooft for replacement Heating Phut etdro: NC Condenser.
Recomactionor new biro* forreplac e: seemElectricWaie rHrsiecocpower,. ted
water Imam
ReconraecSan elite Sxvias Ed elen Cnbl o, Meter liox, el len -4one 10 ro cptaclea
awl :Wing Wares the to siding t soft t installation. Note: New Se v oe
l I n t e a a s c o C b ,will=quiteaetptratop
Rocunnsction or new eircoit for the replacement Of other panrancn!tywired
appliances 1 fixtures.
New druitfor the addition of AIC to an britviduar dwelffugtosit, including
required melee cl tetanal radio. Bode HorrroaarKeziaan fill y GIP li rirorurr
aroma: on rained foxily Omar o_^cap,ed harm Work on a c»sldambriuta,
eimplaa. rawtal, or midi Iarea buPding would rrqubv a rimmed €leat-looi
Com actor.
Ofl ,i
'Ilse vela: of this work i s
Lherebyr Mfj ibis mark will bepertamed in compliance with tteWennrequirements of
Section 1I .42 of theOshkosb Municipal code sad iunher verify lc recounectlorr! installation
Civil] he done En corn lHnno with m� and d Meet is code requirements.
/fl 14CKCVOA - \\NM uik2A 1O
�ral - Jro o` Corso rOCtoa oc Ibncsoxter) (Mr. Pots T (D1e)
Pi'Otr