HomeMy WebLinkAbout0145565-HVAC (furnace & a/c) (1)/ CITY OF OSHKOSH No 145565
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1130 LAAGER LN Owner PETER T /KAREN HIELSBERG Create Date 04/21/2011
Contractor THOMPSON HEATING AND COOLING S Category 502 - Residential -Both Plan
Fuel ✓1 Gas U Oil 1 1 Electric Li Solar U Solid
System ❑ New n Replace ❑ Other
Forced Air u Radiant u Steam u A/C ❑ Vent
1 Electric 1 1 Hot Water 1 Suppl. f Con. Burner
Chimney Type ) Chimney A () Chimney B • Direct Vent 0 Not Applicable
Heat Loss K ) As Approved • Existing n Not Applicable Value
BTU Rate J As Per Plan • Variable () Other Value
Use /Nature SFR / REPLACE FURNACE AND NC, EIV SIGNED BY T RUCK ELECTRIC * *check #2528
of Work
Fees: Valuation $4,800.00 Plan Approval $0.00 Permit Fee Paid $82.00
Issued By: ()r Date 04/21/2011
❑ Permit Voided I Parcel Id # 1310620000
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 901 OTTER AVE OSHKOSH WI 54901 - 5444 Telephone Number 920 -426 -3095
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 O.lHKOlH
Fax (920) 236 -5084
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 Permitfee 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. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion. ,, //
DATE `�'/°
JOB ADDRESS //g 0/¢ 1467674
OWNER — Itar Zs - 74c
CONTRACTOR e 614 p Soti 4 /"-c 4 �c'c C / 6
CHECK Q ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL Was DElectric DSolid SYSTEM ❑New ,Replace
❑Oil DSolar DOther
TYPE
Corced Air DRadiant ❑Steam C4/C ❑Vent DElectric DHot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No Wes - LINER SIZE 3 & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A ❑Chimney B gpirect Vent DOther
HEAT LOSS DAs Approved VExisting ❑Not Applicable
BTU RATE DAs Per Plan Variable DOther Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE �,
VALUE (Including labor and materials) $ `i
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 6
07/07
(2\1 City of Qahklr h
1TviJk+n of iritpecdon Services
llt w t Avenue
PO Box 1 130
f } �((� l Oshktxh W154902.1130
" J H Office 924 23 5 -5050
ON tn[ w4TI Fax 920430 -5084
Electric installation Verificat
(1) (W e) C:!._�
(E . trif� L ontractor Name)
(Address) (City) (State) (Zip Code)
have been- contracted to perform electric installation work fo
Game of p ty contracted to)
at the following address: l L30 LAI:Ariz- - -_ LeJ
(Address where work will be performed)
The nature of the work consists of 7 (Check One or Describe the Nature of Work)
,Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric 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 other permanently wired appliances / fixtures.
Other
The value of t is work is $
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection ! 'nsta o will be done in comp ' 1 manufacturer and Electric code
requiternents.
J