HomeMy WebLinkAbout0144111-HVAC (furnace) .41 CITY OF OSHKOSH No 144111
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2875 FOX TAIL LN Owner SEAN E ELLIOTT Create Date 11/17/2010
Contractor BREWER HEATING Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas u Oil Li Electric U Solar U Solid
System ❑ New 1 151 Replace ❑ Other
u Forced Air ❑ Radiant u Steam J A/C J Vent
L Electric U Hot Water U Suppl. Con. Burner 1
Chimney Type J Chimney A () Chimney B • Direct Vent O Not Applicable
Heat Loss () As Approved 0 Existing ` Not Applicable I Value
BTU Rate J As Per Plan () Variable • Other 1 Value
Use /Nature SFR / Replace furnace. EIV signed by Cumings Electric. * *debit acct
of Work
Fees: Valuation $2,600.00 Plan Approval $0.00 Permit Fee Paid $49.00
Issued By: a l"kt/.1/ Date 11/17/2010
❑ Permit Voided I Parcel Id # 1332060000
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 N8804 DOUGLAS ST RIPON WI 54971 - 9702 Telephone Number 920 - 748 -6494 866 -8C
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.
i l l
/16/2010 TUE 16:26 FAX 920 748 6520 Brewer Heating -• CITY OF OSHKOSH J001 /001
City of Oshkosh
ter
Division of Inspection Services }`
P.O. Box 1130
Oshkosh, WI 54903 -1130 „�"
Phone (920) 236 -5050 -
Fax (920) 236 -5084 0/1- -1K0 /H
ON THE 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
If you are a contractor participating in the Permit rye Account System and have adequate funds, check here
if you want this processed through your account (�
** 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 /t 7 7
J013 ADDRESS o g 7 5 — /' e- A L- L ,
OWNER .5 A' C -001'
CONTRACTOR R I b4J 2. /-1(��9' .. LW-
CHECK E ALL APPLICABLE
USE CATEGORY
.Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL ' bas ❑Electric ❑Solid SYSTEM ❑New 'Replace
❑Oil ❑Solar ❑Other
TYPE
E'F orced Air ❑Radiant ❑Steam ❑A /C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE )1 • 1 & & 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 ❑Not'Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
/7e 441 /2/leg's- fi.,, Act
VALUE (Including labor and materials) $ �6v 0
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) C(iI `m HA- ; f ) S
d 07/07
Received Time Nov. 16. 2010 4:11PM No. 3760
v 17 2010 8:22RM CUMINGSELECTRIC 920 -722 -0768 p.1
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Electric Installation Verification .
lov cow a sc r tc.
(Electrical Contractor Name)
r 0 101 749, 81=8. ill 54957
(Address) (City) (State) (Zip Code)
have been coatracted to pertbrm electric instiJlsfioo work ihr Brewer Heating Inc.
(Name ofputy contracted to)
at the following address: 2875 Foxtail Lane
(Address when work will be premised)
The nature of the wort coodsis ofi (Check One or Desedbs the Nature of Wadt;)
. . _ x _ Reconnection or new dtoodt lbr raplioamaat hot andRac A/C
Reconnection or new circuit fbr replsoernent Sleetda Water Heater or power vented ..
water heater.
RaeoegnemIon of the Service Satrnmoe Cable, Meter Hon, altered= to tecq Caoies
and fghH g fixtures due to / soffit won. No New Service
Enneoee tables will require a saute pat o&
Reconeeetion or neat Ginn& fir the mincemeat dither permanently wired
appliances / fixtures. •
Now aka* for the addition of A/C to an bulliildnal dwelling war (house or the
individual systems is a duplex or eondonriohtm), including required service
eleoasc*! outlets. •
� Other
The value of this work is S 85.00 •
•
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with ruaiufactur+er and Electric code
requirements.
Mays_ / ��� 11/17/10
(Signature "% w an ` Meer) (Print Name of Officer) (Deco)
sou .
Received Time Nov.17. 2010 7:21AM No. 3768