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Home My WebLink About0143699-HVAC (furnace) CD CITY OF OSHKOSH No 143699 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 702 W 20TH AVE Owner ADAM USHANNON M ANDRIS Create Date 10/19/2010 Contractor D & S HEATING AND COOLING Category 500 - Residential- Heating & Ventilating Plan Fuel U Gas Li Oil Li Electric Li Solar So lid System ] New I n Replace ❑ Other u Forced Air LJ Radiant J Steam J NC J Vent Li Electric Li Hot Water f Suppl. 1 _f Con. Burner Chimney Type 7 , ) Chimney A 0 Chimney B O Direct Vent 0 Not Applicable Heat Loss ?, ) As Approved 0 Existing • Not Applicable Value BTU Rate 0 As Per Plan 0 Variable • Other Value Use /Nature SFR / Replace furnace. EIV signed by Rick Steffens Electric. of Work Fees: Valuation $5,030.00 Plan Approval $0.00 Permit Fee Paid $85.00 Issued By: G''i'Y!./.LJ Date 10/19/2010 ❑ Permit Voided Parcel Id # 1408720000 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 W1418 TOWN HALL DR PULASKI WI 54162 - 7517 Telephone Number (920) 660 -0097 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 �_� I I \O�I �J I Fax (920) 236-5084 ON THE WATER 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 fl ** 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 -R-/o JOB ADDRESS 7 0R a (.4 , OWNER/l ,/44/;//// .5 (7) Y6 C / — / a a 7 CONTRACTOR /917S !fegI:,1e C'/Q; CHECK 6d ALL APPLICABLE USE CATEGORY (Sin Family ❑Duplex ❑Multi - Family [Mental ❑Commercial ❑Industrial FUEL ,I4Gas ❑Electric ❑Solid SYSTEM ❑New jet eplace ❑Oil ❑Solar ❑Other TYPE Oorced Air ❑Radiant ❑Steam ❑A/C ❑Vent ['Electric ❑Hot Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED ❑No Ales - 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 fijNot Applicable BTU RATE DAs Per Plan ❑Variable [Other Value U 000 DESCRIPTION / SCOPE OF ALL WORK BEING DONE / p% r. C ,Ylskey capiiQrt VALUE (Including labor and materials) $ J V34� 9;70- - 73 q_ 37 / C Sao- b'.s8_Gs1 ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) R C . S/�C°7� � �-� a�� 3q- 6 S G� 10/18/2010 19:58 19207346655 R.STEFFENS ELECTRIC PAGE 02 Oct. 11 2010 11:10AM CITY OF OSHKOSH INSPECTION No.3214 P. 1 City of Oshkosh bivlsioo of Impeder Services 215 Chmoh Avenue 1•O1 ex 1130 Oshkosh Wf S4003-1190 Office 920.126.5050 C Z E11; Net 920416400 Electric Installation Verification I (We) — (Electrical Contractor Name or Homeowner's Name) /723 !- 'N 6J f � (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: 70 ,�=-- (Address where work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) econnectio or new circuit for replacement eating Pl. • 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. Recomection or new circuit for the replacement of other permanently wired appliances / fixtures. New circuit for the addition of &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 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. /d (Signature of Company 0*. or omeowner) (Print Name) (Date) Received Time Oct, 19. 2010 7:59AM No. 3320 O1 /7