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Home My WebLink About2011-HVAC (boiler) 0 CITY OF OSHKOSH No 144641 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 420 430 N SAWYER ST Owner ZION EVAN LUTH CHURCH Create Date 01/13/2011 Contractor CONDON TOTAL COMFORT Category 510 - Ind. & Comm - Heating & Ventilating Plan Fuel ✓j Gas I ❑ Oil Li Electric Solar ❑ Solid System ❑ New I [71 Replace 1 n Other Li Forced Air ❑ Radiant _I Steam ❑ A/C U Vent 1 Electric U Hot Water Li Suppl. j Con. Burner 1 Chimney Type ) Chimney A O Chimney B 0 Direct Vent • Not Applicable Heat Loss Q As Approved ❑ Existing • Not Applicable Value BTU Rate ( ) As Per Plan 0 ) Variable • Other Value Use /Nature 420 N Sawyer / Replace boiler. EIV signed by owner. of Work I Fees: Valuation $4,190.00 Plan Approval $0.00 Permit Fee Paid $73.00 Issued By: y(/J. Date 01/13/2011 ❑ Permit Voided Parcel Id # 1608860000 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 11 BLACKBURN ST RIPON WI 54971 -0 Telephone Number 920 - 748 -5050 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 Oshkosh, WI 54903 -1130 Phone (920) 236 -5050 Fax (920) 236 -5084 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, whichever is greater. If you are a contractor participating in the Permit fee Account System and have adequate funds, check here if you 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. Application submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. JOB ADDRESS 420 N. SAWYER OSHKOSH, WI 54901 DATE 1 /10 /11 OWNER JERICHO ROAD MINISTRIES n, ZION CHURCH APARTMENTS CONTRACTOR CONDON TOTAL COMFORT, INC. 11 Blackburn St. Ripon, WI 54971 748 -5050 CHECK ALL APPLICABLE USE CATEGORY ❑ Single Family ❑Duplex X Multi- Family ❑ Rental ❑ Commercial ❑Industrial FUEL XGas ❑Electric ❑Solid SYSTEM ❑ New X Replacement [DOH ❑Solar Other: TYPE ❑Forced air ❑Radiant ❑Steam ❑ A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl ❑Con. Burner IS CHIMNEY BEING LINED ❑No ❑Yes - Liner size & Manufacturer Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS ❑As Approved Existing ❑Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value DESCRIPTION / SCOPE OF ALL WORK BEING DONE: REPLACEMENT OF BOILER ,VALUE (Including labor and materials) $4190.00 Fee: $73.00 ELECTRICAL CONTRACTOR (for projects not requiring an EIV form: ENCLOSED V City of Division o In on of Inspection Services 215 Church Avenue PO Box 1130 OfH<OJH Oshkosh 54903 -1130 Office 920 - 0- 236 -5050 ON THE WATER Fax 920 - 236 -5084 Electric Installation Verification I (We) Jericho Road Ministries (Electrical Contractor Name or Homeowner's Name) 429 N. Sawyer Oshkosh, WI 54901 (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: Zion Church Apartments @ 420 N. Sawyer St. Oshkosh, WI 54901 . (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 A/C Condenser. Reconnection or new circuit for replacement Electric Water Heater 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 n rance files 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 $ 100.00 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 compli.nce with manufacturer and Electric code requirements. Y 19 k'l- 7-14 S i ature of ►± r / / � ( parr • c sr Hf meowner) (Print Name) (Date) 07/07