HomeMy WebLinkAbout0100494 HOSHKOSH
ON THE WATER
.lob Address 1180 W 18TH AVE
Contractor MARX MECHANICAL LLC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ALBERT W/LINDA KRUEGER
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100494
03/28/2003
Other J
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$1,300.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$24.50
Date 03/28/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number
(920) 235-6510
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
NAR 2 8 2.005
All information after b~i~e~Uo[~es-lmu-tsst~e~rovided.
Incomplete applications will not be processed.
O/HKO/H
ON TNE WATER
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed tol_nspection 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 participating in the Permit fee Account System and have adequate funds, check here
i£¥ou want this processed through your account ~l
CI-W. CK [] ALL APPLICABLE
USE CATEGORY
[2'Single Family V1Duplex
ElMUlti-Family ElRental F1Commercial Vllndustrial
FUEL l~2"Gas E]Electric F1Solid SYSTEM F1New I~l~eplace
F1Oil [] Solar [] Other
Ii,Forced Air []Radiant [2]Steam DA/C []Vent []EleCtric []Hot Water E]Suppl. V1Con. Burner
IS CHIMNEY BEING LINED l~qo ElYes - LINER SIZE
Note: Alt chitnne'ys 'shall be Sized per the BTU's being vented.
CHIMNEY TYPE
ItEAT LOSS
BTU RATE
[]Chimney A
[]As Approved
V1As Per Plan
[3Chimney B
[3Existing
[3Variable
DESCRIPTION OF ALL WORK BEING DONE
& MANUFACTURER
[3Direct Vent
VINot Applicable
F1Other Value
[3Other
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not apPlicable, a separate Electrical Permit is required.
9/02
~ '~03i2B/2008 1B:28 ~202~72B~ ~EZ ELECTR[~ P~E ~L
Electric Installation Verification
(I) ('We) Beez E.l.e,ctfi~ Inc.
~21 W. 12th ~L~ WI 54902
have been contracted to perform electric installation work for Marx Mechanical,
at the following address: 1,180 W. 18th Ave,
The nature of the work consists of: (Check One or Describe th~ Nature of Work)
]Keconnection or new circuit for replacement Hearing Plant and/or A/C Condenser.
P-,econnection or new cimuit for replacement Electric Water lie. atto'.
Keconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation, Note: New Service Entrance Cables
will roquire a separate permit.
Keoonnection or now dr~uit for other permanamly wirod appliances / fixturgs,
The value of this work is $150.00
I hereby writ~ this work will be performed by an employee of this company and ~-ther verify the
reconnection / installation will be done in compliance w/th ~turer and Electric code
~rements.
($lsnature ~£ Company Officer)