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HomeMy WebLinkAbout0145686-HVAC (furnace) el) CITY OF OSHKOSH No 145686 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2120 CRANE ST Owner JOANNE DAHSE LIFE ESTATE Create Date 05/03/2011 Contractor BETTER HOME HEATING & AIR CONDII Category 500 - Residential- Heating & Ventilating Plan Inspector Fuel U Gas U Oil I U Electric Li Solar U Solid System n New 1 n Replace 1 n Other u Forced Air u Radiant u Steam 1 j NC u Vent Electric L Hot Water u Suppl. U Con. Burner Chimney Type 10 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 / Replace furnace. EIV signed by Kollmann Electric. of Work Fees: Valuation $1,559.00 Plan Approval $0.00 Permit Fee Paid $34.00 Issued By: al'-)'j,/o1/ Date 05/03/2011 El Permit Voided I Parcel Id # 1212450000 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 W1 Oshkosh, WI 54903 -1130 Phone (920) 236 -5050 Fax (920) 236 -5084 Of HKOJH 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 $100.00 plus the normal permit fee, which ever is greater. OR If you are a contractor participating in the Permit fee Account System and have adequate funds, check here, if you want this processed through your account fl ** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. DATE --°96 JOB ADDRES cq/c? Q el>..4-,..frt_O 00 OWNER � • .Q _ � ' CONTRACTOR 1 ` st% Asr ' i / CHECK WI ALL APPLICABLE USE CATEGORY Gl$ingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial FUEL El as DElectric ❑Solid SYSTEM ❑Ne E(pRS W F D Doll ❑Solar ❑Other TYPfi APR 2 ti 2011 orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water � ;' ��� JE � IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MAN AtEfOf& ERViC,F %; r)TVISION Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS DAs Approved ❑Existing ❑Not Applicable BTU RATE DAs Per Plan ❑Variable ❑Other Value DESCRIPTION / SCOPE OF ALL WORK BE G ONE CPU 7'1.4g -tee. ' VALUE (Including labor and materials) $ '/S D ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) (0_14474 07/07 05/02/2011 07:23 9202737965 KOLLMANN ELECTRIC PAGE 01/01 Dig or Oshkosh Division of inspection $GrVIC24 .011115) 213 Church Avenue PO Box 1130 Oshkosh WI 549Q3.1130 Office P20- 236.5050 - Fax 92Q- 236•5O54 Electric Installation Verification . I (We) / ---ke ,- .4 G . (Electrical Contractor Name or Homeowner's Name) /0150X 026 W. Ai 4.j, 4. t 5Y77 r (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: la0 ale, S (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 A/C 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 Electricals Contractor. Other o- The value of this work is S /O . 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. /.i .:ter, / J7rc 7�! ffi'' a 42 -` // "" Sign= /of Company Officer or Homeowner) (rint Name) (Date) 07107 Received Time May. 2. 2011 8:17PM No. 5475