HomeMy WebLinkAbout0144133-HVAC (furnace) CITY OF OSHKOSH No 144133
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1840 SIMPSON ST Owner Create Date 11/18/2010
Contractor MARK WEBER HEATING & COOLING IN Category 500 - Residential- Heating & Ventilating Plan
Fuel ( ✓J Gas Li Oil Electric U Solar Li Solid
System Li New Q Replace n Other
L✓j Forced Air Li Radiant J Steam J A/C L J Vent
Li Electric L J Hot Water LJ Suppl. J Con. Burner
Chimney Type J Chimney A 0 Chimney B • Direct Vent O Not Applicable
Heat Loss ) As Approved 0 Existing • Not Applicable Value
BTU Rate () As Per Plan () Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Vector Electric. * *debit acct
of Work
Fees: Valuation $2,400.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: L //yyvi/ Date 11/18/2010
Permit Voided Parcel Id # 1407350000
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 1075 ISLAND ESTATE CT OSHKOSH WI 54901 -1341 Telephone Number 235 -1523
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.
11/18/2010 04:56 FAX 1Z1002
City of Oshkosh
Division of Inspection Services
P.0, Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236-5050 • 1KO�
Fax (920) 236-5084
ON TH1• WATFR
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 narticipatin! 1n the Perm - e Account Stem and have adequate funds, check here
t ou 'nt this •r' sed t ,u.h our acc, ,nt
** 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 whcn such is required, will not be
processed for Permit Issuance and will be returned for completion. ` /�` $/ v
DATE <
JOB ADDRE / D e I(e) $(1 1, M)
OWNER '
CONTRACTOR / iy ',r5
CHECK Ed ALL APPLICABLE
USE CATEGORY
E ngle Family °Duplex °Multi- Family ORental °Commercial Dlndustrial
FUEL i2has DElectric °Solid SYSTEM DNew Pitcplace
0011 °Solar DOther
TYPE •
orced Air °Radiant ❑Steam DA/C °Vent []Electric °Hot Water DSuppl. • OCon. Burner
IS CHIMNEY BEING LINED 10 °Yes - LINER SIZE & MANUFACTURER,
Note: All chimneys shall be sized per the NU TU's being vented.
CHIMNEY TYPE °Chimney A °Chimney B Iirect Vent DOther
HEAT LOSS DAs Approved °Existing • of Applicable
BTU RATE DAs Per Plan °Variable DOther Value
DE EPTION / SCOPE OF ALL WO K BEING E f� G/ '1 NG '5
� ✓1 ✓ 4# - ! no -. ! ' ��
•
VALUE (Including labor and materials)
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
Received Time Nov. 18. 2010 4:54AM No. 3791 olio'
11/18/2010 04:55 FAX Z001
ci sDrialA City of Oshkosh
ZIS Church Avenue
PO Box 1130
Oahkoel, wl 3490)•1130
in g :(11�/i o 920.2364010
• A. Pax 920 - 236.5094
Electric Installation Verification
I(We) ,ht l' '- -- ,
lectrical Contractor Name or Homeowner's Name)
r � 4d' ei
(City) (State ) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
•
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
X Reconnection or new circuit for replacement Heating Plant and/or
Reconnection or new circuit for replacement Electric Water H ater or power vented
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 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 $ A. 0 . a J .
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.
Received Time 18. 2010 4: -No. 3191 `/,4,
1 et re or company Oft�e szr HAmM Wm r l / n ,— ..•., ,