HomeMy WebLinkAbout0140734-HVAC (furnace & a/c)0
CITY OF OSHKOSH
No 140734
OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address
920 W 9TH AVE
Owner LINDA A WOKOSIN
Create Date 04128/2010
Contractor
BREWER HEATING
Category 502 - Residential -Both
Plan
Fuel
✓ Gas
Oil
Electric
Solar
L Solid
System
New
[�✓ Replace
] Other
✓ Forced Air
Radiant
Steam
✓ A/C �
Vent
Electric
]Hot Water
Suppl.
Con. Burn re
Chimney Type
Chimney A
Chimne B
y
Direct Vent Not Aoolirahla
Heat Loss
As Approved
Existing
Not Applicable
Value
BTU Rate
As Per Plan
Variable
Other
Value
Use /Nature SFR
of Work
/ Replace furnace and a/c.
El V signed by Cumings Electric. * *debit acct
Fees: Valuation $4 830 00 Plan A I
Issued By:
pprova $0.00 Permit Fee Paid
C�yc�
Permit Voided
$83.50
Date 04/28/2010
Parcel Id # 0605840000
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 N8804 DOUGLAS ST RIPON WI 54971 - 9702 Telephone Number 920 - 748 -6494 866 -8(
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.
04/28/2010 WED 11:05 FAX 920 748 6520 Brewer Heating --- CITY OF OSHKOSH
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
10002 /003
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1 ] 28,
Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in fees being doubled 01' $100.00 plus the
normal permit fee, which ever is greater.
OR
** Advisory - For applicable projects, an EIectrical 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.
JOB ADDRESS_ ��D W, [ �` �� — ati7�y�a
OWNER 1 tiaQ
WQ
CONTRACTOR
R 12erCt/6TL?t/G
yytG
CHECI{ Q ALL APPLICABLE
USE CATEGORY
M.Ingle Family ❑Duplex ❑Multi- Family ❑Recital ❑Commercial ❑Industrial
FUEL Bras OElectric ❑Solid SYSTEM ❑New'eplace
❑Oil ❑Solar ❑Other
TYPE
Q?F'orced Air ❑Radiant ❑Stearn A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED O No / ❑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 ❑As Approved ❑Existing ❑Not'Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
.e— M L r'-P g .h ce. am�.&
VALUE (Including labor and materials)
n
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) t,GvY► �� /� C c-
07/0
Received Time Apr.28, 2010 10:54AM No.0785
Apr 28 10 11:24a CUMINGS ELECTRIC, INC, 920 - 722 -0769 p,3
Oiwioe e(lsipecdan Senkrr
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o.tto.r wt 54901.11So
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Fix t20.216•5094
Electric Installation Verification
I (we) CUNINGs ELECrBIC INC.
(Electrical Contractor Name)
P 0 LOX 749, KEEUH. V1 54957
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for _ BBEfr M HEATING LINDA WOKOSIN
(Name ofpatty contracted to)
at the following address: 9201W 9TH AVE.
(Address wh= work will be performed)
The nature of the work consists of (Chock 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 tiding / 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 is a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is S 85.00
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 maaufactU= and Electric code
requirements_
Received Time Apr,28, 2010 12:22PM No.0789
BICEABD J VEKZEL
(Print Name of Officer)
4/28/10
(Date)
S42