HomeMy WebLinkAbout2010-HVAC (furnace & a/c) 0 CITY OF OSHKOSH No 140577
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1234 LIBERTY ST Owner SHARON KURCZEK Create Date 04/20/2010
Contractor MARK WEBER HEATING & COOLING IN Category 502 - Residential -Both Plan
Fuel J Gas 1 Oil 1 f Electric 1 1 I Solar I 1 Solid
System [l New
Q Replace E Other
J Forced Air Li Radiant u Steam u NC —J Vent
U Electric U Hot Water I I Suppl.
I 1 Con. Burner 1
Chimney Type K ) Chimney A () Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss 0 As Approved () Existing • Not Applicable Value
BTU Rate ( ) As Per Plan 0 Variable • Other Value
Use /Nature SFR / REPLACE FURNACE AND A/C, EIV SIGNED BY VECTOR ELECTRIC "debit acct
of Work
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $85.00
Issued By: :3--•(--DS--- Date 04 /20/2010
❑ Permit Voided I Parcel Id # 1203570000
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 1075 ISLAND ESTATE CT OSHKOSH WI 54901 -1341 Telephone Number 235 -1523
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.
04/20/2010 10:53 FAX 0001
City of Oshkosh '
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084
aU=I
WATFR
KVAC 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 y o tu a re a contracto participaeln4 n the Permit - ,c oun system a n ha ad ep ate fundds. chec here
1 • want 4 •ro sse• the.. our Ice, r
** 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 EDT when such is required, will not be
processed for Permit Issuance and will be returned for completion. l
DATE 4 //2...C)//6
2C) /D
JOB ADDRESS ) a3 C 1 L•-}
OWNER )fpL?L_. ("NO 0
CONTRACTOR
CHECK ® ALL APPLICABLE
USE CATEGORY
ilgSizgle Family °Duplex °Multi- Family :Rental ❑Commercial , Qlndustrial
FUEL Qs ❑Electric °Solid SYSTEM °New , keplace
0011 °Solar ❑Other
TYPE
[ azed Air °Radiant °Steam ekiC °Vent DElectric °Hot Water ❑Suppl. °Con. Burner .
IS CHIMNEY BEING LINED *o °Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A DChimney B ,irect Vent °Other
HEAT LOSS DAs Approved DExisting ONot Applicable
BTU RATE DAs Per Plan [Wadable °Otthe
DESCRIPTION / SCOPE OF .ALL WORK BEING DONE4 / / t< M •Ji‘k
11u..611 A. tar _L 0
VALUE (Including labor and materials) $ ..561 e D ? 61
Received.Time 20 n2010;;10:53AMpNo, 0643ot requiring anE1VForm) _. -�—
IJl.LIr a a
04/20/2010 10:54 FAX
Q002
City of Oshkosh
Divbion of Inspection Services
219 Church Avenue
PO Boa 1130
� ! Oshkosh W1 34907.1130
Ol�t►l011: Office 930.236.5050
Fox 920.4364064
Electric Installation 'Verification
I (We) ' ; , ,, ,
(Electrical Contractor Name or Eomeowner's Name)
(A dress) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
(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 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
The value of this work is $ 356 ,
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.
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Received Time Apr, 20 2010 10:53AM"'No 0643 (Print Name) (Date)