HomeMy WebLinkAbout2011-HVAC (furnace) CD CITY OF OSHKOSH No 145084
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 603 SCHOOL AVE Owner KEVIN M /MATTEA F ALLEN JR Create Date 03/08/2011
Contractor BETTER HOME HEATING & AIR CONDII Category 500 - Residential- Heating & Ventilating Plan
Fuel L)✓ Gas Li Oil 1 Electric U Solar Li Solid
System n New 1 0 Replace n Other
u Forced Air u Radiant u Steam u NC _f Vent
LI Electric Hot Water U Suppl. L Con. Burner
Chimney Type () Chimney A () Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss K ) As Approved 0 Existing • Not Applicable Value
BTU Rate As Per Plan () Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Kollman Electric.
of Work
Fees: Valuation $1,600.00 Plan Approval $0.00 Permit Fee Paid $34.00
Issued By: �� /rAtA2/ Date 03/08/2011
n Permit Voided I Parcel Id # 0201450000
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 1054 AMERICAN DR NEENAH WI 54956 - 1305 Telephone Number 920 - 733 -2161
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
Oshkosh, WI WI 54903 -1130
Phone (920) 236 -5050 —
Fax (920) 236 -5084 OJHKOf H
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 3 -3 - 1/
JOB ADDRESS (.o b .3 kc.,L --a-/ et me •
OWNER 414... a Q11 Q� t CONTRACTOR �i , wn s.. 4
.D0
CHECK II ALL APPLICABLE
USA CATEGORY
Mingle Family ❑Duplex ❑Multi - Family DRental El Commercial El Industrial
FUEL 126as DElectric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar DOther
T/
❑Forced Air ❑Radiant ❑Steam DA/C ❑Vent DElectric ❑11RE er
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MANUF WU[ 11011
Note: All chimneys shall be sized per the BTU's being vented.
DEPARTMENT OF
ititi
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent a QJ 1 J.TY DEVELOPMENT
HEAT LOSS DAs Approved DExisting DNot ApplicaaSPECTION SERVICES DIVISION
BTU RATE DAs Per Plan ❑Variable DOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE 0c7OC. 1 qxti„n..8,./ce,
VALUE (Including labor and materials) $ 1 L O o. co
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) Vir--4-/M-a-.^.„
_ 3v01/
07/07
03/07/2011 09:46 9202737965 KOLLMANN ELECTRIC PAGE 01/02
City of Oshkosh
Division of Inspection Services
215 Mach ch Avanua
PO Box 1130
Oshkosh WI 548034130
Office 920.236 -5050
PI= Fax 92Q•236.50s4
Electric Installation Verification
I (We) /�/ &. , ,-C zz
(Electrical Contractor Name or Homeowner's Name)
PO SOX gC a„ `, w- 3 -P7 7
• (Address) (City) ty) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
X63 s oh/ 4d.
(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
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 AIC 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 / fI'
r--� f,
d /' C en/ 0,1 �' e / ,` -
The value of this work is $ 7s .
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 compliance with manufacturer and Electric code requirements.
"fa Te.-e^cel-7 /1:40 .1 -... .37fr/0
(Si of compan Officer or Homeowner) (Print Name) • (Date)
09107
Received Time Mar. 7. 2011 9:42PM No.4871