HomeMy WebLinkAbout2010-HVAC (furnace & a/c) 0 CITY OF OSHKOSH No 143712
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1256 WALNUT ST Owner JEAN M SPANBAUER Create Date 10/19/2010
Contractor A -1 HEATING & NC INC Category 502 - Residential -Both Plan
Fuel U Gas I Oil Li Electric Solar H Solid
System ❑ New 1 121 Replace 1 ❑ Other
u Forced Air ❑ Radiant ❑ Steam 4 A/C u Vent
U Electric U Hot Water u Suppl. U Con. Burner
Chimney Type ( ) Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss r() As Approved 0 Existing 0 Not Applicable Value
BTU Rate J As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace and a /c. EIV signed by Bell Electric.
of Work
Fees: Valuation $3,370.00 Plan Approval $0.00 Permit Fee Paid $61.00
Issued By: (2r1,1_,/,/ Date 10/19/2010
❑ Permit Voided I Parcel Id # 1204510000
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 W8078 HILLCREST CT HORTONVILLE WI 54944 - 9301 Telephone Number 920 - 779 -8838
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
vi oO Inspection Division of Inspection Services '
P.O. Box
Oshkosh WI WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084
HVAC PERMIT APPLICATION
All information after bold categories must 'De provided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or ma_led to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Commencing work without permit(s) will rsult 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 throughyour account n
** Advisory - For applicable projects, an Electrical Installation Veri cation (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performe by the homeowner) must be submitted
with the permit application. Applications submitted without an E when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE
JOB ADDRESS i as(o /h ccf Sf 'RECEIVED
OWNER J6f)A1 ■PAAIAP - u_Ee OCT 1 9 2010
CONTRACTOR A -1 HenNpg & A/C DEPARTMENT OF
P.O. Box 311 COMMUNITY DEVELOPMENT
CHECK ® ALL APPLICABLE Hortonville, WI 54944 INSPECTION SERVICES DIVISION
USE CATEGORY
0§ingle Family GDuplex ❑Multi- Family ❑Rental ❑Commercial ❑Industrial
FUEL L s ❑Electric ❑Solid SYSTEM ❑New lif place
❑Oil ❑Solar ❑Other
TYPE
tla Srced Air ❑Radiant ❑Steam Q1'C/C ❑Vent [Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED 1x24"0 ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑either i°
HEAT LOSS DAs Approved fisting ❑Not Appli mb1e
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
22, o 0o g rct nr o2b yic- a fon/ /3 s c z ' Pi ivE /C
VALUE (Including labor and materials) $ 3 3 76
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) EP.
10/14/2010 THU 8:37 FAX 920 733 2 /l.i Watters riumoing ivviivvz.
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Electric Installation Ve fication
(Electrical Contractor Na c)
(Address) (City) , (State) (Zip Code)
have been contracted to perform electric inatatlationn work f ` r A.-/ tieG d'!h 0 /tic ,
a i ■ •‘ q f 0 (Name o r party contracted to)
�-t_e e rift c. d— /
C,
at the following address: /675 (P _ L.l -1444± S •
(Address where work ill be performed)
The nature of' the work consists of (Check One or Describ. the Nature of Work)
_,�_ Reconnection or r ew circuit rot replacement eating Plant and /or A/C Condenser.
__ Reconnection or new circuit for replacement •lectric Water Heater or power vented
water heater. •
w . Reconnection of the Service Entrance Cable, eta Box, alterations to receptacles
and lighting fixtures duc to siding / soffit i , stallation. Note: New Service
Entrance Cables will require a separate pe nit.
__...... Reconnection or new circuit for the replaccme 1 of other permanently wired
appliances / fixtures.
__,,,_ „ New circuit for the addition of A/C to un lndiv"dual dwelling unit (house or the
individual systems in a duplex or condomi ium), including required service
electrical outlets.
Other
The value of this work is $.. __
i hereby verify this work will he performed by an employee of this company and further verify
the reconnection / installation will be done: in compliance ith manufacturer and Electric code
requI Ctnents.
I J - f(i /Y )
t..iv.lrc t{onpuny Officer)
(Print Name o Officer) (Date)
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