HomeMy WebLinkAbout0144926-HVAC (furnace) 0 CITY OF OSHKOSH No 144926
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2620 W 20TH AVE Owner LARRY R KOEPPEN Create Date 02/17/2011
Contractor ALANNE CLIMATE CONTROL LLC Category 500 - Residential- Heating & Ventilating Plan
Fuel u Gas U Oil u Electric j Solar Li Solid
System Li New Q Replace [] Other
u Forced Air u Radiant _J Steam j A/C u Vent
U Electric 11 Hot Water U Suppl. Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature SFR (RENTAL) / REPLACE FURNACE, EIV SIGNED BY YOURR ELECTRIC * *check #9346
of Work
Fees: Valuation $1,950.00 Plan Approval $0.00 Permit Fee Paid $40.00
Issued By: - Date 02/17/2011
❑ Permit Voided Parcel Id # 1316480000
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 2971 SUNSET POINT LN OSHKOSH WI 54904 - 1008 Telephone Number (920) 312 -1228
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 RECEIVE
Division of Inspection Services
P.O. Box 1130 FEB 1 6 2011
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 DEPART MENT OF
Fax (920) 236 -5084 COMMUNITY DEVELOPMTr K01
INSPECTION SERVICES D i ON THE WATER
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
if you want this processed through your account fl
** 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 - / -f(
JOB ADDRESS 21c2- A) ` 2.6 "►1i c t
OWNER L. akky l ?spa v.1
CONTRACTOR J CidOillAS eLm T&L is J( LL
CHECK FE ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi - Family Mental ❑Commercial ❑Industrial
FUEL was DElectric ❑Solid SYSTEM DNew DReplace
❑Oil El Solar DOther
TYPE
.Hl~orced Air DRadiant ❑Steam ❑A/C ❑Vent DElectric ❑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 DChimney B DDirect Vent DOther
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable DOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE `% L... r< zie4l�
VALUE (Including labor and materials) $ 7 T 5 0
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) Aheie CIL6C7`2/
07/07
b 16 11 05:29p Joe Hicks 920 779 4439 p.1
•
21.1 Char* Amos
PO sae 113
gym: osutosi we 5.215.216-113. L
Am 920-234-5064 , .
Electric Insertion Verification
I (We) o LI,Yr E/e4 CLC
AP . c (Electrical Contractor Name or Homeowner's Name) •
. , T ; • 3/7 ,1'.j , 1 7, .3/
O (City)
(State) . (rap Cam)
accept the mspoomlnlity to .. I. . the electric work as stated below, at the followinfil address:
(Address where work wall be performed)
The nature °phis work consists of (Cbeek.One ar Describe the Nature of work)
...r.i !teccemwison o new circuit for repbcement Heating imd o A/C II .Ii I..s /,- ,
Reconnection or new Circuit forreplacement Electric water heater_
Water Heater arpo — vied
Reconnection of the Service ce Entrance Cable, Meter Box, alterations to - .-. r. -.
and lighting fixtures due to siiditrg / soffit motion. Note: New -.
Entrance Cables wilt require a separate p�
Reconnection or new circuit for the replacement of oth er permanently • • i - -
appliances /Thrums.
New circuit for the addition of A/C to an individual dwelling , .., , ..
required service electrical outlets. Note: Homeowners cars only do • own
electric on asingle. family owner occupied home. Work on a ., , • , • ,
duple, rem, or world-use bidl rig would raisin e a licensed El . • ..
Other
m t
value of work is $ -5erulce (i '6O C
1 hereby vet* this work will be performed in compliance with the Lice mgtdremeits of
Section 11 arfthe Oshkosh Municipal code and further verify the rejection / won
will be dog i c omojliaaoc with manufacturer and Electric code
, f _ ■ _.'al 1 1 . /j14y, /jc,
..- ..•... Compsny nor ) / (Print Now) r
( .
07/07
Received Time Feb. 16. 2011 5:25PM No. 4706