HomeMy WebLinkAbout0144482-HVAC (furnace) / CITY OF OSHKOSH No 144482
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 824 WINDWARD CT Owner CHAD J BORK/CHRISTINE A BELLIN Create Date 12/28/2010
Contractor BREWER HEATING Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas Li oil Li Electric U Solar Li Solid
System [] New J 121 Replace n Other
u Forced Air u Radiant Li Steam Li A/C u Vent
U Electric j Hot Water H Suppl. U Con. Burner
Chimney Type L) Chimney A () Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate ( ) As Per Plan 0 Variable • Other Value
Use /Nature SFR / REPLACE FURNACE, EIV SIGNED BY CUMINGS ELECTRIC * *debit acct
of Work
Fees: Valuation $2,460.00 Plan Approval $0.00 Permit Fee Paid $47.50
Issued By : c�lir. Date 12/28/2010
❑ Permit Voided Parcel Id # 1522460000
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 N8804 DOUGLAS ST RIPON WI 54971 - 9702 Telephone Number 920 -748 -6494 866 -8(
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.
/23/2010 THU 12:30 FAX 920 748 6520 Brewer Heating -f-.-. CITY OF OSHKOSH 0001/001 City of Oshkosh
Division of Inspection Services
P.O. Box 1130 ij
Oshkosh, WI 54903 - 1130
ell
Phone (920) 236 -5050
Fax (920) 236 -5084 O f HKO f H
ON THE 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 - 128. 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 ou are a contractor •artici•atin_ in the Permit -e Account 5 stem and have ade unds check here
ifvou want this processed through your account
** 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 when such is required, will not be
processed for Permit Issuance and will be returned for completion.
,` DATE / .2 -;'3 -- / "il
JOB ADDRESS 82 `"� W »i O wft v
OWNER -kfkO .Bo' (e—
CONTRACTOR g 1244/ Pen-TM/6 ., ; 4G
CHECK Ed ALL APPLICABLE
USE CATEGORY
FNingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial 0Industrial
FUEL ❑Electric ❑Solid SYSTEMew ❑Replace
❑Oil ❑Solar ❑Other
:JAPE
'�D orced Air ❑Radiant ❑Steam ❑A /C ❑Vent ❑Electric 0Hot Water ❑Suppl. ❑Con. Burner
/ / IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE M. II-. & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ,Direct Vent ❑Other
HEAT LOSS DAs Approved ❑Existing ❑Not
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
F wifwo -u 4 flay 0-nl.+.1—
VALUE (Including labor and materials) $ a-'1 6 O ,
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) vvv ' S
cJ 07/07
Received Time Dec.23. 2010 12:15PM No.4169
, c 28 2010 2:51PM CUMINGSELECTRIC 920 - 722 -0769 p.1
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Fee �7:111
Electric Installation Verification .
rov _ mum aLlICIZIC nrC.
(Bleotrial Contractor Name)
! O soz 749, • rn 5ilif
(Address) (city) - (State) (Z Dada)
have been contracted to pat= °Leotido installed= vast fbr Brewer Heating .111 ,
(Nape ofpony c t;aaed so)
a the nddmes: _ 824 Windward Court
(Address where wade will be pafio®,d)
wr .
The mare ado walk Gondata oe (Cheek Ono arDeacribo the Neter° of Wier
Recenseetion oc new amok Sr nvraceatent Reeilisflent miller MC Omeleatet•.
Reconnection or new oironit ibr replsoceicat Metric Water Fimisr or power vented ..
water beater.
• Reeoaoeeaaa of the Santee Batman Gable, Meter Box, alteeatima to reoeptaeies
tmd lighting fixtures due to Ming / soffit manioc. Notes tier/ Service
Romeo Cables will require a septets permit
Rscomection or new drunk for me replacement ofadheepa m t1ywired ..
anima / fixture&
New chug for the addition of A/C to as incifiddeardinsibiz w (bottee or the
iad(,idast systems in a duplex or required service
elecnioal outlets.
Other
The value of this work its 55.00
i hereby verify this work will be performed by an employee of Ibis company end further verify
the reoomsectioa / installation will be done in compliance with rant corer sad Bleccric code
,� ../ r w lag= 3 12/28/10
(Signature l am. mpat + fi Boa) (Print Name of Officer) (Dale)
Received Time Dec.28. 2010 1:51PM No. 4199