HomeMy WebLinkAbout0144123-HVAC (furance) 0 CITY OF OSHKOSH No 144123
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 915 GRAND ST Owner RICKY R/SUSAN R CAVANAUGH Create Date 11/17/2010
Contractor MARTENS HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas Li Oil U Electric U Solar f Solid
System ❑ New 0 Replace ❑ Other
u Forced Air u Radiant u Steam ❑ A/C u Vent
U Electric U Hot Water U Suppl. Li Con. Burner
Chimney Type 0 Chimney A O Chimney B • Direct Vent O Not Applicable
Heat Loss (-) As Approved 0 Existing • Not Applicable Value
BTU Rate K() As Per Plan () Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Ace Electrical Services. * *debit acct
of Work
Fees: Valuation / $2,368.00 Plan Approval $0.00 Permit Fee Paid $46.00
G
Issued By: Date 11/17/2010
❑ Permit Voided Parcel Id # 1002820000
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 111@
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 O ����
Fax (920) 236 -5084 ON THE WATER
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 klall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Commencing work without pernnit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I • u are a contractor • artici • ati in the Permit ee Accoun S st-m and h • ve. a • e • • to unds check here
if you want this processed through your account f /3 -/a
DATE
JOB ADDRESS Yl S 6- at ad Si
OWNER k (avanc4 h RECEIVED
CONTRACTOR_.I filar `fi ► t = 0 L P9 NOV 1 7 2010
DEPARTMENT OF
CHECK H ALL APPLICABLE COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
use CATEGORY
ingle Family IaDuplex C7Multi- Family Dental ❑Commercial C1Tndustrial
FUEL Eilk<s °Electric ❑Solid SYSTEM ONew
Other gieplace
°Oil ❑Solar
TYPE
orced Air °Radiant °Steam OAJC °Vent °Electric DHot Water °Suppl.00on. Burner
IS CHIMNEY BEING LINED COYes - LINER SIZE & MANUFACTURER.
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A DChimney B irect Vent 00ther
SEAT LOSS L As Approved °Existing °Not Applicable
BTU RATE DAs Per Plan °Variable °Other Value
DESCRIPTION OF ALL WORK BEING DONE T
!.A /.ice .. • /i.���.
VALUE (Including labor and all materials including light fixtures) $ 3 v g,00
ELECTRICAL CONTRACTOR QR1Electric Installation Verification form attached(lfReplacement)
Elec Heal installation of new /replacement equipment shall be done by licensed contractor.
jiLf t,D0
3/02
City of Oshkosh
160101r Di visioi onnsPection
215 Church Avenue Serfs
PO Box 1130
Oshkosh W1 5 4902-1130
ON TM— Ofrrae 920. 236.3F►SO
Fax 9 236.
Electric Installation Verification
i .11
( (We) a 0 s
(Electrical C. Sc� c/iCe fr. •' Nance) cr" S L L ,
LG
4
• `n. Si
(Address) O AI • W • (Q 3
(City) (State) (Zip Code)
have been contracted to perform electric installation work for
2
(Name of party contracted to
at the following address: • /
(Address where work will be performed)
The nature of the work fists of : (Check One or Describe the Nature of Work)
i Reconnection or new circuit for 1 eplacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alt
lighting fixtures due to siding / soffit installation. to receptacles and
gtsllatin�n. New Service Entrance
Cables will
require a separate perazit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $_____L — �
i here ereby verify this work will be -
here ecv / installation will be orzned by an employee of this company and further
requirements. done in contplia a wig n�nufact rer and Electric verify the
......,„V ...."-‘° 2 (Signature of rnpany Officer) /C,,y/ e . / _ _
(Print Name of Officer) (Date)