HomeMy WebLinkAbout0145988-HVAC (furnace) ID CITY OF OSHKOSH No 145988
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1824 DOTY ST Owner CLEMENT P /KATHRYN GOODACRE JR Create Date 05/20/2011
Contractor A -1 HEATING & A/C INC Category 500 - Residential- Heating & Ventilating Plan
Inspector Nicole Krahn
Fuel (J Gas LJ 011 LJ Electric Li Solar LJ Solid
System 0 New Q Replace 0 Other
u Forced Air Lf Radiant J Steam L NC HI Vent
Electric Hot Water u Suppl. LJ Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss 10 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 Bell Electric.
of Work
Fees: Valuation $1,850.00 Plan Approval $0.00 Permit Fee Paid $38.50
Issued By: 1( Date 05/20/2011
0 Permit Voided Parcel Id # 1401210000
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 W8078 HILLCREST CT HORTONVILLE WI 54944 - 9301 Telephone Number 920 - 779 -8838
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
Fax (920) 236-5084 Al ED E
R nr.��
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VAC PERMIT APPLICATION
All information after bold categories must be provided. MAY 1 9 2011
Incomplete applications will not be processed.
DEPARTMENT OF
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection S-U�PMENT
Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in fees beiii§4366Teini
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 n
** 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 =quiz' ed, will not be
processed for Permit Issuance and will be returned for completion.
DATE
JOB ADDRESS /S i c > S f
OWNER tok G-DDala Crt...
CONTRACTOR A -1 Heating & AIC
P.O. Box 311
CHECK ® ALL APPLICABLE Hortonville, WI 54944
US CATEGORY
@Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL IE16s ❑Electric ❑Solid SYSTEM ❑New Iial place
❑Oil ❑Solar ❑Other
T
orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED pISTo ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A .❑Chimney B ❑Direct Vent IJC$ her Pr
HEAT LOSS DAs Approved ❑Existing ❑N c plicable o ��
BTU RATE ❑As Per Plan ❑Variable sr* ''?Vatue
DESCRIPTION / SCOPE OF ALL WORK BEING DONE �2.it -�� j /i ze-4
?h, 7c ,4t.crte.) k& 75 c osvA-=ri v8 � oa o
VALUE (Including labor and materials) $ l 8 £ —
ELECTRICAL CONTRACTOR (for projects not requiring an EN Form) u1C.X.
05/18/2011 WED 13 :01 FAX 920 733 2713 Watter5 plumbing Ghnniinnr
4)(,-Lat OELS ' °N AVH:L l 101 'OZ 'A 'eW awil pan d
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Electric Installation Verification
(Electrical Contractor Narne) •
S ox // F 1F II4ShA 14./1 .r Y952.
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for /3/•—/ /YtGt !��, try e
V tir o�it cr e 9o /o -• 23 ,z- a y�/ (Name of party contracted to)
• at the following address: / g� v` f �'��� !-�
(Address where work will be performed)
•
The nature of the work consists of: (Check One or Describe the Nature of Work)
/geconncctio or new circuit Far 're la Heatan Plant and/or A/C Condenser. P 8
��. Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection or the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance (tables 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 (house or the
vidual systems in a duplex or condominium), including required service
electrical outlets.
Other
•
•
•
The value of this work is S ~
I hereby verify this work will he performed by an employee oFthis company and further verify
the reconnection / installation will be done in compliance with manufacture] and Electric code
rcyuiremrnts.
•
(Signatur •
o f Cotn1 >atty Officer) (Print Name of Officer) (Date)
•
•
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