HomeMy WebLinkAbout0144110-HVAC (boiler) 0 CITY OF OSHKOSH No 144110
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 907 OREGON ST Owner DONALD E BASLER REV TRUST Create Date 11/17/2010
Contractor MARK WEBER HEATING & COOLING IN Category 510 - Ind. & Comm - Heating & Ventilating Plan
Fuel U Gas U 00 U Electric U Solar 1 u Solid
System 111 New Replace 0 Other
L Forced Air Li Radiant a Steam _I u NC L j Vent
U Electric u Hot Water H Suppl. Li Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature COMM / Replace boiler. EIV signed by Vector Electric. * *debit acct
of Work
Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $62.50
Issued By: Qj /a_f Date 11/17/2010
III Permit Voided Parcel Id # 0900720000
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.
11/17/2010 05:56 FAX lj 001
City of
Division sion of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130 CA
Phone (920) 236-5084 236-5050 Of HK01H
Fax (920)236 -508
e3N THP 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 au ar ,. contra • r . arttei' , - i • in the • r i -- Account s • and 1 - ade. uale .n• chec here
if you want this processed through your account 1"
** 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 ///17 ii 4
JOB ADDRESS q0) o *eisic..)
OWNER Q»3 ISA '7.74.: - R i ^.
CONTRACTOR P Of kiet lt . ra
CHECK El ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi- Family ❑Rental fr °Industrial
FUEL `Ids ❑Electric ❑Solid SYSTEM ❑New 42place
DOH ❑Solar DOther
TYPE
❑Forced Air °Radiant ❑Steam DA/C ❑Vent °Electric Skot Water ❑Suppl.. OCon. Burner
IS CHIMNEY BEING LINED I.No ❑Yes - 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 DExisting ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
ESCRIPTION / SCOPE OF ALL WORK BEING DO Ree4c:i Ai i 1 7 7 4%; 1 05 77 koLtir
VALUE (Including labor and materials) $ 3c. -) C.-)
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) . —
Received Time Nov, 17. 2010 5:55AM No.3762 07/07
11/17/2010 05:56 FAX Qt1002
City of Oshkosh
Division of Inspection Services
215 Church Avenue
. ® PO Box 1130
OsWeosfi W1 34903 -1170
�T 11.1 Y(x Officio 920.23e.5050
• Fax 970.236.5081
Electric Installation Verification
(We) itArdifi, (N >?� 'rC_ �►
(Electrical Contractor Name or Homeowner's Name)
(A dress) Y r .
(City) (State) (Zip Code)
accept the responsibility to perform th electric work as stated below, at the following address:
•4
(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 ofother 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 multi -use building would require a licensed Electrical
Contractor,
Other
The value of this work is $ /o, t' t .
Y 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 Nov, 17 5:55ANF-No. 3162
111 re Ot 1.0111OenV ntticorht NnmonwnAV 1 \1_ ....�