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HomeMy WebLinkAbout0143901-HVAC (furnace) I CITY OF OSHKOSH No 143901 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 827 W 11TH AVE Owner SHIRLEY E /JAY D PUESTOHL Create Date 11/01/2010 Contractor MARK WEBER HEATING & COOLING IN Category 500 - Residential- Heating & Ventilating Plan Fuel u Gas 1 ] Oil J Electric Solar U Solid System [] New 1 12I Replace 0 Other u Forced Air _J Radiant J Steam J A/C J Vent 1 IJ Electric 1 Hot Water U Suppl. Li Con. Burner Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable Heat Loss ( ) As Approved () Existing • Not Applicable Value BTU Rate 7 , ) As Per Plan 0 Variable 0 Other I Value Use /Nature SFR / Replace furnace. EIV signed by Vector Electric. * *debit acct of Work Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $55.00 Issued By: lii74//1� Date 11/01/2010 0 Permit Voided I Parcel Id # 1303170000 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 1075 ISLAND ESTATE CT OSHKOSH WI 54901 -1341 Telephone Number 235 -1523 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. 10/31/2010 15:06 FAX 001 City of Oshkosh Division of Inspection Services P.O. Box 1130 0 Oshkosh, WI 54903 -1130 Phone (920) 236 -3050 Fax (920) 236 -5084 Ulf -KO ON THA WATFR 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 1 ou •re a co, actor •articl•a 'l • to the • -r it •e aunt S s em a • have ••e•uate nds c, ck her - i • want is .roc - ed thr• u - h our • • nt R� ** 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 /0 " /--/C) JOB ADDRESS V? roc/ g fri+ OWNER L/ h1 Pti-E CONTRACTOR 4 0J- 10 77J C CHECK EI ALL APPLICABLE USfrCATEGORY S ingle Family DDuplex ❑Multi- Family ❑Rental ❑Commercial ©Industrial FUEL as ❑Electric °Solid SYSTEM DNew eplace ❑Oil ❑Solar DOther TYPE ❑Forced Air DRadiant DSteam ❑A /C DVent ❑Electric of Water ❑Suppl.. ❑Con. Burner IS CHIMNEY BEING LINED ‘OYes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. • CHIMNEY TYPE ..1 A ❑Chimney B ODirect Vent ❑Ocher HEAT LOSS DAs Approved ❑Existing ❑Not Applicable BTU RATE DAs Per Plan ❑Variable ❑Other Value DES / RIPTION / SCOPE OF ALL WORK BEING NE L> 4 T-7 r - S/ 6 lAi A /I r & VALUE (Including labor and materials) $ 3006•0 ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 07/07 Received Time Oct. 31. 2010 3:03PM No. 3505 10/31/2010 15:06 FAX a002 • City oPOSltkoah Oiviainn of hopeulion hrvicds 21 S Church Avenue PO Bon 1130 Oshkosh WI 34903-1130 frigyram orKoo 920.236•5010 K 544.1 Fox 9204364014 Electric Installation Verification I(We) • '• i s ., _ _ . (Electrical Contractor Name or Homeowner's Name) (City) (State) (Zip Code) accept the �ressponsibility 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 for 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 multiuse building would require a 1lcensed Electrical Contractor. Other The value of this work is $ /4d, b 0 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, Received Time 31. � ��PM —No. ��y /0 r3l pi!) 10 , 10 3.03 3505 �.1� di C QIl1DanV t I F1nmpnwnnr 1 /n_r.. •�_..- . s • .