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Home My WebLink About0144124-HVAC (furnace) 0 CITY OF OSHKOSH No 144124 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 3747 GLENBROOK LN Owner PAUL WEAVER / JOAN DOMSKE Create Date 11/17/2010 Contractor MARTENS HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan Fuel Gas 1 j Oil U Electric 1 Solar U Solid System [] New 1 121 Replace 1 — 1 Other u Forced Air u Radiant a Steam ❑ A/C J Vent ❑ Electric 1 f Hot Water Li Suppl. Con. Burner Chimney Type 10 Chimney A 0 ) Chimney B 41 Direct Vent ❑ Not Applicable Heat Loss 0 As Approved () Existing • Not Applicable Value BTU Rate () As Per Plan O Variable 0 Other Value Use /Nature Mobile Home / Replace furnace. EIV signed by Ace Electrical Services. **debit acct of Work Fees: Valuation $2,207.00 Plan Approval $0.00 Permit Fee Paid $44.50 Issued By: X2`1 Date 11/17/2010 ❑ Permit Voided Parcel Id # 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) 236 -5050 /"`� Fax (920) 236 -5084 CJJHKTJH ON THE WHTFR HVAC PERMIT APPLICATION All information after bold categories must be provided. Incornplete 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 549034128. 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 throukh your account n DATE //- /3 JOB ADDRESS 37 6-1 e brook Lan ...� R Dorn s RECEWED owlvE Joa II'' CONTRACTOR MQ rtens /4pc&4 n9 * NOV 1 7 2010 DEPARTMENT OF CHECK Fa ALL APPLICABLE COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION USfi. CATEGORY Single Family DDuplex °Multi- Family Mental ©Commercial ❑industrial FUEL Idtias D Electric ❑Solid SYSTEM °New replace DOil ❑Solar ❑Other q ? � E lForced Air °Radiant ❑Steam DA/C °Vent °Electric °Hot Water CDSuppl.°Con. Burner IS CHIMNEY BEING LINEDIIo °Yes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B iiKirect Vent °Other HEAT LOSS DAs Approved °Existing [Not Applicable BTU RATE DAs Per Plan °Variable ❑Other Value DESCRIPTION OF ALL WORK BEING DONE __.._ VALUE (Including labor and all materials including light fixtures) $ Q o?O / 8 00 ELECTRICAL CONTRACTOR OR XElecttic installation Verification form attached(if Replacement) Electrical installation of new /replacement equipment shall be done by licensed contractor. *414450 3/02 Y of oohkoch DiVigiCin 215 Chinc Avenue sarvi PO Box 1130 Q u Oshkosh WI 54 902 -1 130 r p� Eq n ?a/kr92O- Fax 9 236 -5p Electric Installation Verification (I) (We) Q ✓'/'l S (Electrical C •.. ,1 Name) i C o, / 4, . Le- Tre46g2. P9 060 57 O • &J/ Q co cer 1.4.4.) (Address) � ! � ( 1ty) / /� (State) (Zip Code) have been contracted to pert electric installation work for JDQ omskc_ (Name of party contracted to) at the following address: 7 (Address where work will be performed) The nature of the work consists of : (Che One or Describe the Nature of Work) Reconnection or new circuit for reph� � . Recoction or new circuit for r eating Plant and/or A/C Condenser. Reconnection of the Service replacement Electric Water Heater. C� � Sees due to siding � ullatio� ox, to receptacles and tiles will require a s Note: New Service Entrance Reconnection or new circuit r o.� permanently Yd appliances / fixtures. The value of this work is S ,5 d D I hereby verjri hereby verify this installation kn ll be performed by an employee requirements. will be done in compliance ite tuffs u a company a further verify the with h manufacturer and Electric code ..„V , ...4 • (Signature of ► • r y Officer) /C Z // -/3- / 0 (Print Name of 0fi7cer) (Date)