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HomeMy WebLinkAbout0143748-HVAC (furnace) 14 CITY OF OSHKOSH No 143748 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2801 WINDHURST DR Owner MR/MRS TED J VANDYKE JR Create Date 10/21/2010 Contractor MODERN SHEET METAL INC Category 500 - Residential- Heating & Ventilating Plan Fuel U Gas U Oil Li Electric _ Li Solar U Solid System ❑ New I n Replace I 0 Other u Forced Air u Radiant L j Steam u NC u Vent Electric u Hot Water Su I. J PP u Con. Burner Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • Not Applicable Heat Loss 7 , ) As Approved () Existing 0 Not Applicable Value BTU Rate 10 As Per Plan 0 Variable • Other Value Use /Nature SFR / Replace furnace. EIV signed by homeowner. of Work Fees: Valuation $3,445.00 Plan Approval $0.00 Permit Fee Paid $62.50 Issued By: 9 Date 10/21/2010 ❑ Permit Voided I Parcel Id # 1331300000 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 2180 AMERICAN DR _ NEENAH WI 54956 - 0 Telephone Number (920) 733 -4713 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. .u1,20, 2006 12:52PM inspection services No. 7864 P. 1 C ity of Oshkosh 1 ivision of Inspection Services F O. Box 1130 �, C shkosh, WI 54903 -1130 i Paone (920) 2365050 1 F tx (920) 236 -5084 C� ON THE WAT 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 $100.10 plus the normal permit fee, which ever is greater_ OR 'you are a contractor participating in the Permit fee ccount System and have adequate f hei e ijyou want thl�- proces throug pour a ccount f l DATE ' /D J )B ADDRESS 2 9 / ,� 4Jc RECM CWNER CONTRACTOR Me2dnr Agate2r OCT 1 2010 DEPAR T EviEly E OF CHECK EI ALL APPLICABLE COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION � L' jE CATEGORY gle Fam %,y °Duplex ❑Multi - Family 'Mental ['Commercial Dlndustrial FUEL _Gas DEIectric ❑Solid SYSTEM ❑New k!. ! place ❑Gil ❑Solar ❑Other F T giE orced Air DRadiant DSteam DA/C ❑Vent ❑Electric ©Hot Water ❑Suppl. ['Con, Buiner D CHIMNEY BEING LINED ONo °Yes - LINER SIZE & MANUFACTURER N ate: All chimneys shall be sized per the BTU's being vented. C T MNEY TYPE ❑Chimney A °Chimney B ['Direct Vent ❑Other H AT LOSS DAs Approved (]Existing ❑Not. Applicable // �� B'I1J RATE DAs Per Plan ['Variable ❑Other Value �f0 0 DES " ' ON OF ALL WO' - BEING DONE / / / e ii e o /J CL ' Ago Ago /' � � rf� ` .I i .a 21 ��i V 1`LU $ � ` � � (0)-, 5 ELECTRICAL CONTRACTOR ❑ For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be attached. if not attached or not applicable, a separate Electrical Permit is required_ 9/02 59E ° °N WdLl :E OLE °OZ ° ; aw!1 pania�a� F R 1 ' l ocern 6k , •k i1r- Cisy idOshkash Ori*ioa of lsopoz a Swiczs 213 Church Awn= PO Sox 1 130 W Oshkosh 54903 OfSc 92o o 920- 236-SQ50 Pie 920- 236 -S44 Electric Installation Verification I (We) —led 14/ -2 (Electrical Contractor N ol�rneawner's Name) Zarid - _X (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 tor replace- eating Pl n i and/or A/C Condenser. Reconnection or new circuit for replacement ec ' ' • er 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. Afore: Homeowne can only do their own electric on a single family owner occupied home. Work on a condominium, duplex, rental, or multi -use buildinn'would require a licensed Electrical Contractor. Other The value of this work is $ 7,T OC I hereby verify this work will be performed in compliance with the License requirements of Section 11 - of the Oshkosh Municipal code and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. mar /�� 1)4.01Y6 1 a l t? /C) • (signature of Co • Of iiccr or g weer (Print Name) V (Date ■• ■ ■ ■ 07/07 ■• ■