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Home My WebLink About0144752-HVAC (furnace) 0 CITY OF OSHKOSH • No 144752 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 633 EVANS ST Owner RACHEL L RIVERS Create Date 01/26/2011 Contractor DRUCKS PLUMBING & HEATING CO IN( Category 500 - Residential- Heating & Ventilating Plan Fuel U Gas LJ Oil L Electric Q Solar 1 J Solid System El New 1 121 Replace 0 Other I IJ Forced Air LJ Radiant LJ Steam _I A/C _J Vent Li Electric LJ Hot Water I Suppl. U Con. Burner Chimney Type 0 Chimney A O Chimney B • Direct Vent 0 Not Applicable Heat Loss 7 , ) As Approved 0 Existing O Not Applicable Value BTU Rate 0 As Per Plan n Variable • Other Value Use /Nature SFR / Replace furnace. EIV signed by Drucks Electric. of Work • Fees: Valuation $4,100.00 Plan Approval $0.00 Permit Fee Paid $71.50 Issued By: a/7' ,CAV Date 01/26/2011 ❑ Permit Voided I Parcel Id # 1102620000 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 P 0 BOX 355 MENASHA WI 54952 - 355 Telephone Number 920 - 426 -2654 • 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 oOfsh Division o In on of Inspection Services P.O. Box 1130 Oshkosh, WI 54903 -1130 Phone (920) 236 -5050 Fax (920) 236 -5084 01 IK9/H 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 participating in the Permit fee Account System and have adequate funds. check here ifyou want thisprocessed through your account (l ** 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. Co DATE 04// JOB ADDRESS t 3 3 C1/4-t") S J REC FIVED CONTR !J ACTOR ci4-,S JAN 2 6 201 CHECK ALL APPLICABLE DEPA I lveV OF COMMUNITY DEVELOPMENT USA CATEGORY INSPECTION SERVICES DIVISION ONIS mgle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial FUEL CE1bas ❑Electric ❑Solid SYSTEM ❑New a' eplace ❑Oil ❑Solar ❑Other TYPE ‘iitForced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water DSuppl. ❑Con. Burner IS CHIMNEY BEING LINED!Io ❑Yes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B birect Vent ❑Other HEAT LOSS DAs Approved RlExisting ❑Not Applicable BTU RATE DAs Per Plan ZYariable ❑Other Value DESCRIPTION / SCOPE OF ALL WORK BANG DONE EP(A C ' 0.65 .- VALUE (Including labor and materials) $ 9/ DO °'" ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 07/07 City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh 54903 -I130 Office 920.0- 236 -5050 Fax 920-236 -5084 Electric Installation Verification I (We) S (Electrical Contractor Name or Homeowner's Name) 3l Y . .t) 16 1c241f 1 ESL (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: C� 3 3 s (Address where work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) Reconnection or new circuit for replacement Heating Plant 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 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 AJC 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 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 complianc - with manufacturer and Electric code requirements. . • /26/, (Signature of Company Officer or Homeowner) (Print Name) (Date) 07/07