HomeMy WebLinkAbout0144120-HVAC (furnace) 0 CITY OF OSHKOSH No 144120
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 553 W 16TH AVE Owner DAVID M /LAURA J FELTEN Create Date 11/17/2010
Contractor MARTENS HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas U Oil I Electric Li Solar Li Solid
System n New 1 4 Replace [] Other
u Forced Air u Radiant U Steam Li A/C HI Vent
Li Electric u Hot Water J Suppl. U Con. Burner
Chimney Type C) Chimney A O 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 SFR / Replace furnace. EIV signed by Ace Electrical Services. * *debit acct
of Work
Fees: Valuation /� $1,407.00 Plan Approval $0.00 Permit Fee Paid $32.50
Issued By: c..uiY7 .0 Date 11/17/2010
Permit Voided Parcel Id # 1301370000
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 PO BOX 514 OMRO WI 54963 - 514 Telephone Number 920 - 685 -0111
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) 36 -508
Fax (920) 236-5084 50
4 Of -1KOIH
36 -508 fit\
ON THE WA ER
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 participatine in the Permit fee Account System and have adequate funds. check here
if you want this processed through your account f
DATE `/ — 10
JOB ADDRESS 553 i) . / h +n five
OWNER Dave Felfen RECEIVED
CONTRACTOR 11 i -, I i4 • , - ♦ -) NOV 1 7 2010
DEPARTMENT OF
CHECK H ALL APPLICABLE COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
US§ CATEGORY —
gligingle Family uplex DMulti Family ❑Rental OCommercial DIndustrial
FUEL tL'�Gas DElectric ❑Solid SYSTEM DNew tifteplace
DOil °Solar °Other
E
orced Air °Radiant °Steam DA/C °Vent DElectric DHot Water OSuppl.DCon. Burner
IS CHIMNEY BEING LINED I to DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE °Chimney A °Chimney B 2HDirect Vent DOther
HEAT LOSS DAs Approved DExisting °Not Applicable
BTU RATE DAs Per Plan °Variable DOther Value
DESCRIPTION OF ALL WORK BEING DONE `✓d! / i
VALUE (Including labor and all materials including light fixtures) $ 1 1 01
ELECTRICAL CONTRACTOR OR ❑ Electric Installation Verification form attached(If Replacement)
Electrical installation of new /replacement equipment shall be done by licensed contractors
3x
3/02
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
a/ �y� Oshkosh W154902 -1130
RCM Al<�l,.G! H Office 920. 9364050
ON THE WATER Fax 9 -236 -5 0114
Electric Installation Verification
(I) (We) fY1 ,A1 1i' s 4-each, q 4 I (�
(Electrical Contrdctor Name) S Oedic S LLC.
,
1 x SI Oruro G<Jl 5 3
(Address) (Ci
(City) (State) (Zip Code)
have been contracted to perform electric installation work for T)q / te
(Name of party contracted to)
at the following address: S,53 & , / h
(Address where work will be performed)
The nature of the work consists of : (Check One or Describe Nature of Work) -
Reconnection or new circuit for replacement Heating Plant andIor A/C Condenser.
Reconnection or new circuit for replacement Electric 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 other permanently wired appliances / fixtures.
Other
The value of this work is $ /5:0. cc
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 manufacturer and Electric code
requirements.
(Signature of o . Officer`"� /1 13 /U
mpany ) (Print Name of Officer) (Date)