HomeMy WebLinkAbout0143517-HVAC (furnace) e l) CITY OF OSHKOSH No 143517
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 972 E SUNNYVIEW RD #35 Owner TOM BEYER Create Date 10/07/2010
Contractor WESLEY HEATING & COOLING INC Category 500 - Residential- Heating & Ventilating Plan
Fuel p Gas Oil E Electric Solar - li
_ - ❑ I � Solid
System 0 New Q Replace [1 Other
Q Forced Air LRadiant Q Steam ■ D A/C 1 rij Vent
Q Electric Li Hot Water Q Suppl. Q Q Con. Burner
Chimney Type Q Chimney A 0 Chimney B • Direct Vent Q Not Applicable
Heat Loss Q As Approved • Q Not Applicable Value
BTU Rate 0 As Per Plan Variable • Other Value
Use /Nature MOBILE HOME / REPLACE EXISTING FURNACE, EIV SIGNED BY KOLLMANN ELECTRIC * *check #99849
of Work
Fees: Valuation $2,417.00 Plan Approval $0.00 Permit Fee Paid $47.50
Issued By: Date 10/07/2010
Permit Voided J Parcel Id #
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 3220 BASLER LN OSHKOSH WI 54901 -0 Telephone Number 920 - 235 -6951
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
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 fe
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 permits) 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 Ice Account System and have adequate funds. check here
if you want this processed through your 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 EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE q ‘t>
JOB ADDRESS o`Za
OWNER ••■■q d.. q
CONTRACTOR �,, .• t 1 ` _ A .4
CHECK ® ALL APPLICABLE
USE CATEGORY
[Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL kGas ['Electric ❑Solid SYSTEM ❑New OReplace
❑Oil ❑Solar ❑Other
•
TYPE
Forced Air ❑Radiant ❑Steam ['A/C [Went ['Electric [Mot Water DSuppl. ['Con. Burner
IS CHIMNEY BEING LINED I N o ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per a BTU's being vented.
CHIMNEY TYPE ['Chimney A ❑Chimney B JLQDirect Vent ❑Other
HEAT LOSS DAs Approved {Existing ❑Not Applicable
BTU RATE DAs Per Plan ['Variable VitOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
VALUE (Including labor and materials) $ AkA 1.rl .
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07 07
Ro ass 414
Oliio& WI.014130
l.i;
Electric Installation Verification
I (We)
(ElectiodContractor Name or 'shame)
(Address) (• (gtt) (v Coda
accept the impossibility to paten the elcalric work as stied below, *the Mowing address:
(npdraanurbmm w�uk wtu ae per$oermd)
The nature of dw work cousins of: (Check One or Daubs the Nature of Work)
Recennectigoor new circuit for replacement Hewing Plant and/or A/C Comdcaser.
- Reconnection or new circuit for replacement Electric Water Heater or power vaned
water heeaee.
.� ».
Reconocction ofitce $eevioe Eatr*i s CA MOW Bolt' alterations to ri gepaaolea
and limit fixtures due to gal isstalietion. Noce: New &n ice
&drance Cables will requite s separate permit.
- Reconnection or new cireuk for dm replacement ofolhor permeaeemt1y wired
Warn= / fixture.
- New twit ibr the addition ofMC to an inskvideol demillegenit, including
requircd so aks electrical makes. Noce: liososowners con only do *sir 44FR
dearly on asingie. ,, y omnsraid home. Work on a combed :don,
dew moot or endeksse bne dho wouldmet e alkalised Siecolost
cantroctor.
Other
•
The value of this work is S .73
I barmy verity this week rich bo performed in oomplienoe with the LW:me requirements of
Section 11 - of the *elm* Municipal code and Mbar verity the taeoaeedoo / irutdlstioln
will be done in compliance with ammullaszer and Studio cods rogaitementa.
� r ice A t*" /0 ` -- /t'
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