HomeMy WebLinkAbout0141007-HVAC (furnace & a/c) (9 CITY OF OSHKOSH No 141007
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1720 DOTY ST Owner RONALD T /LISA E KELLY Create Date 05/17/2010
Contractor BETTER HOME HEATING & AIR CONDII Category 502 - Residential -Both Plan
Fuel II] Gas 1 1 Oil LJ Electric LJ Solar LJ Solid
System n New 1 Q Replace
[] Other
4 Forced Air LI Radiant LJ Steam u NC Li Vent
LJ Electric LJ Hot Water LJ Suppl. U Con. Burner
Chimney Type ( ) Chimney A () Chimney B 0 Direct Vent • Not Applicable
Heat Loss ( ) As Approved O Existing • Not Applicable Value
BTU Rate O As Per Plan () Variable 0 Other Value
Use /Nature SFR / Replace furnace and a /c. EIV signed by Seckar Electric.
of Work
Fees: Valuation $11,850.00 Plan Approval $0.00 Permit Fee Paid $179.00
Issued By: Date 05/17/2010
0 Permit Voided I Parcel Id # 1400180000
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.
Cite of Oshkosh ss2
Division of Inspection Services
P.O. Box 1130 MAY 1 3 2010
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 DEPARTMENT OF
Fax (920) 236-50g4 COMMUNITY DEVELOPMENT OfHKOIH
INSPECTION SERVICES DIVISION TI-IF WATFR
HVAC PERMIT APPLICATION
All information alter 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 Mere
if von want this processed rhrouvh vour 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 , C / r /0
JOB ADDRESS / Z
OWNER A- ik OJF
CONTRACTOR . a►!kirei
CHECK EL ALL APPLICABLE
USV CATEGORY
IR Ingle Family DDuplex DMulti- Family DRental DCommercial Dlndustrial
FUEL 17 as DElectric ()Solid SYSTEM DNew ()Replace
DOB DSolar DOther
T
Wowed Air DRadiant °Steam [WC °Vent DElectric °Hot Water DSuppl. OCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE OChimney A OChimney B DDirect Vent DOther
HEAT LOSS DAs Approved DExisting DNot Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DESCRIPTIO / � SCOPE OF ALL WORK BEING DOVE ft � ` ♦ .� � -1 ,
-�� o. / (0° o G
VALUE (Including labor and materials) $ a// fD,
ELECTRICAL CONTRACTOR (tor projects slot secpdrieg an EW Farm) - '
City of Oshkc h
' ® PM$ion of ion services
215 Chl ch Asa,c
PQfl c 1130
Oshlkcah WI 54903 -1130
Deice 920436.5050
M WA R Fax 920,236-5084 •
•
Electric Installation Verification
gy
Y (We) SR
(Electrical Contractor Name or. Homeowner's Name)
1 �0 •O tYJE 'C V,4vZit ( IN ECOtho = Og6
(Address) (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 fbr 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 $, Z,S O 0
/ 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.
T PI/We S& —j /• —
(Signature of lopany Offiver or Homeowner) (Print Nam) (Dato)
070'
Received Time May. 17. 2010 6:54AM No. 1038