HomeMy WebLinkAbout0144369-HVAC (furnace) 10 CITY OF OSHKOSH No 144369
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 625 FRANKLIN ST Owner MATTHEW S /MOLLY A JERGER Create Date 12/14/2010
Contractor MARTENS HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas Oil L] Electric J Solar 1 Solid I
System 0 New Q Replace I [] Other
u Forced Air u Radiant j Steam J NC ] Vent
Electric ] Hot Water U Suppl. (J Con. Burner
Chimney Type 0 Chimney A n Chimney B • Direct Vent O Not Applicable
Heat Loss ( ) As Approved 0 Existing • Not Applicable Value
BTU Rate J As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Ace Electrical Services. * *debit acct
of Work
Fees: Valuation $4,300.00 Plan Approval $0.00 Permit Fee Paid $74.50
Issued By: 0/Y2'L./L Date 12/14/2010
❑ Permit Voided I Parcel Id # 0703030000
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.
12/13/2010 20:03 9206850490
City of Oshkosh MARTENS HEATING PAGE 01/02
Division of Inspection Services .
P.O.Box1130
Oshkosh, WI 54903 -1130 -
Phone (920) 23 6-5050
Fax (920) 236 -5084 CO:DOVE
ON THE WATER
. HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete appli cadnnc 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
I • u are a co - • • • rtici • , t ' . the • _ L . . cco_ . t S steel it • ave :: • _rte un - _ ,, - . ere
if vo want. this processed through your account yi
DATE i d-/ 1 3 f 10
JOB ADDRESS 6 a 5 Fran k 1 i n
OWNER ill 4, i e rl e r
CONTRACTOR Yf a r t" 0, n, - j 4 I r•
•
CHECK Bi ALL APPLICABLE
U E CATEGORY
Single Family °Duplex CIMulti Family ClRental ❑Commercial DIndustrial
FUEL I *as °Electric ❑Solid SYSTEM °New I, eplace
❑Oil ❑Solar ❑Other
E
orced Air ❑Radiant OSteam °AJC °Vent []Electric []Hot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LAVED Io Yes - L SIZE & MAMWACFURE1
Note: All chimneys shall be sized C9 thoe BTU's being•vented, •
CHIMNEY TYPE []Chimney A ❑Chimney B (rDirect Vent ❑Other
SEAT LOSS OAs Approved °Existing ONot Applicable
BTU RATE DAs Per Plan []Variable °Other Value
DESCRIPTION OF ALL WORK BEING DONE V, . ,/.0147"F
VALUE (Including labor and all materials light futures) $ 300 4 ' 9
ELECTRICAL CONTRACTOR CZ KElectric lostoRation Vedic tioo form attacbedufRepletenxnt)
Electrical installation of new /replacanau equtpment .hall be done by Hcettsert contractors
Received Time Dec. 13. 2010 7:18PM No.4042 •
3/02
12/13/2010 20:03 9206850490 MARTENS HEATING PAGE 02/02
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Fax soee
Electric Installation Verification
(Z) (We) u q vl s Irk yt q t► ��
(Electrical C.�, �... �., Nom) r�, � A l Gt'��rc`¢ -L
S O U � cc�JiC LL
`s � II Ka
(City) ( (Zip Code)
have been contracted to perform electric installation work for
(Name of party ted . to)
at the following mss: r
•
(Adams where work will be pied)
The nature of the work data of : (Chock One
or Describe Nate of Work)
___L/ or new circuit for
Reconnection or new circuit for rep t Heating pigs or AJC Co .
Reconnection of the Service Entrance c Water Heater.
mace C
g futures due to siding / ie, Meter Box, alterations w. receptacles and soffit
R files will require a se installation. Note: New Service F
tioa •
or new circuit for other p3, Vices / fixtures. R ther
The value o f this work is $ pa
� this work will be performed by
°n / installation will be done in Y Pwith of tli;s comp a ny nd and further verify verify the
requirements. . � with ,�,� aa Electric code
,./-
(Signature of • . y cer) ��iR1 'L f 42-, /3 c�
(Print Name of Officer)
(Date)
Received Time Dec,13. 2010 7:18PM No,4042