HomeMy WebLinkAbout0145087-HVAC (furnace) 0 CITY OF OSHKOSH No 145087
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 734 W 10TH AVE Owner PORTSIDE APARTMENTS LLC Create Date 03/08/2011
Contractor BREWER HEATING Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas u Oil u Electric Li Solar -1 Li Solid 1
System f] New 0 Replace ❑ Other
u Forced Air u Radiant ] Steam ] A/C Li Vent
Li Electric U Hot Water Li Suppl. ❑ Con. Burner
Chimney Type ( ) Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss ) As Approved 0 Existing • Not Applicable Value
BTU Rate ( ) As Per Plan 0 ) Variable • Other Value
Use /Nature Condo / Replace furnace. EIV signed by Cumings Electric.
of Work
Fees: Valuation $1,640.00 Plan Approval $0.00 Permit Fee Paid $35.50
Issued By: aVi9t,21 Date 03/08/2011
❑ Permit Voided I Parcel Id # 1305712000
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 -8C
To schedule inspections p ease call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, S rvice, 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 s not performed within two business days from the time the project is ready.
03/01/2011 TUE 15:57 FAX 920 748 6520 Brewer Heating CITY OF OSHKOSH 121002/002
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130 w'`
Phone (920) 236 -5050
Fax (920) 236 -5084 OJHKOJH
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 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
1 ou are a contractor ,artici•atin. in the Permit -e Account S stem and have ade uate ands check here
if you want this processed through your account
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the EIectrical
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 P rmit Issuance and will be returned for completion.
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DATE t
JOB ADDRESS 13 7 CI)
1 1/
OWNER AI f o•ra y gt1A -t
CONTRACTOR giRbCtf ��G'TZ!✓ LYtG
CHECK Q ALL APPLICABLE
USE CATEGORY
'Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL C`ias ❑Electric ❑Solid SYSTEM ❑New ;replace
❑Solar DOther
TYPE
,@(Forced Air ❑Radiant ❑Steam ❑A /C ❑Vent ❑Electric ❑Hot Water DSuppl. ❑Con. Burner
C IS CHIMNEY BEING LINED DNo ❑Yes - LINER SIZE I ' & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A ❑Chimney B DDirect Vent DOther
HEAT LOSS DAs Approved ❑Existing DNot
BTU RATE DAs Per Plan ❑Variable DOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
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VALUE (Including labor and materials) $ 11/, `r p
3 .
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 02,nuLr
07/07
Received Time Mar. 1. 2011 3:41PM No. 4812
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Electric Installation Verification
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cros zazc INC. .
1(wa) cr : .
(Electrical Contactor Name)
P.0 3OZ 749, tlEitILLII, VI 54957
' (Address) ' (City) . (State) (Zip Code)
i Brewer Heating, Inc.
have been contacted to perform electric instefation work for r
} { {{{ (Name of party contracted to)
i i4 t . 5 ,. •
at thefoll0wingaddress: 734 W. 10th. Oshkosh
(Address where work will be per ad)
f l'#
The nature of the work consists of (Check One or Describe the Nature of Work)
_g___ Reconnection or new circuit for rcpt eat Heating plat and/or A/C Condenser.
Reconnection or new circuit for ceplaceasent Electric Water Healer or power vented ..
seater heater. • '
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and fighting fixtures dna to siding / soffit won. Note: New Service
lakanoe Cables will require a separate permit.
Reoomnootiof or new eirauit for the replacement of other permanently wired
appliances / fixtures. •
New circuit for the addition of A/C to an individual dwelling rnr/i (house or the
Individual systems lis a duplex or condominium), including required service
cleetrical outlets. M 1
f
50.00 l''"";
The value of this work is S sr, � i a i14
I hereby verify this work will be performed by in employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements. { T ' .� , ; a 4
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(Signature ' • aspul • !ricer) (Print Name of Officer) (Date)
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