HomeMy WebLinkAbout0144116-HVAC (furnace) 10 CITY OF OSHKOSH No 144116
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2455 VIKING CT Owner GERALD R/JOY TAPPY Create Date 11/17/2010
Contractor ANDREW R MEIER Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas U Oil Electric u Solar Solid
System [] New 1 F. Replace 1 ❑ Other
u Forced Air u Radiant u Steam u A/C LI Vent
U Electric [ j Hot Water U Suppl. i Con. Burner
Chimney Type r() Chimney A • Chimney B O Direct Vent 0 Not Applicable
Heat Loss L) As Approved • Existing 0 Not Applicable Value
BTU Rate 7 , ) As Per Plan 0 Variable 9 Other Value
Use /Nature SFR / REPLACE FURNACE, EIV SIGNED BY RICK STEFFENS ELECTRIC * *check #3284
of Work
Fees: Valuation $2,757.00 Plan Approval $0.00 Permit Fee Paid $52.00
Issued By: (1 ( .- Date 11/17/2010
❑ Permit Voided I Parcel Id # 1312180000
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 6814 ENGE DR WEST BEND WI 53090 - 9571 Telephone Number (262) 391 -3002
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 of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 • ■•
HVAC PERMIT APPLICATION R R, Y ED
All information after bold categories must be provided. NOV 1 5 2010
Incomplete applications will not be processed.
DEPARTMENT OF
• • Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection 6ataieht,IPFOCHWEIO J NT
Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in fees belit6135ffialoM06.rillokasio
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 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 1/ d
�5 5 V ,
JOB ADDRESS k ' n l el � r"
OWNER jer(yli
CONTRACTOR 4/ .JAtr5/.4494 Cv ki 5
CHECK El ALL APPLICABLE
USE CATEGORY
ntagle Family ❑Duplex ❑Multi - Family :Mental ❑Commercial ❑Industrial
FUEL ,...;113s ❑Electric ❑Solid SYSTEM :New ,eplace
0011 ❑Solar ❑Other
T� d Air ❑Radiant ❑Steam ❑A /C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑Yes - LINER SIZE
& MANUFACTURER
Note: All chimneys shall be sized p r the BTU's being vented.
CHIMNEY TYPE ❑Chimney A himney B ❑Direct Vent ❑Other
HEAT LOSS DAs Approved xisting ❑Not Applicable
BTU RATE DAs Per Plan Variable ❑Other Value
DE CRIPTION / SWIPE OF ALL WORK BEING DONE Q ®'' A T; : °e C
Y ri° vq`1 AQ()3(c AA4
VALUE (Including labor and materials) $ c2 7 v 7
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) kC L 54-cW1N1s lec.
07/07
City of Oshkosh R E 1 `� E D
Division of Inspection Services
215 Church Avenue NOV 1/ I r� 2010
PO Box 1130 'Y Y /
Oshkosh WI 54903 -1130
/ < JH Office 920- 236 -5050 DEPARTMENT OF
ON THE WATER Fax 920- 236 -5084 COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric Installation Verification
7?(CK 5741 I g7C_ C.-
(Electrical Contractor Name or Homeowner's Name)
''I C td 1 s4 ie% s # ?7 4, )
(Address) (City) (State) (Zip Code)(9i,f
accept the responsibility to perform the electric work as stated below, at the following address:
a � /5
/////7.7 � • s 96y
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
> connection or new circuit for rep acement eating 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 fiktures 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 multi - use building would require a licensed Electrical
Contractor.
Other
The value of this work is $ And
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.
XIX S s // /
(Signature of Company O cer +r Homeowner) (Print Name) (Date)
07/07