HomeMy WebLinkAbout0146194-HVAC (a/c) CITY OF OSHKOSH No 146194
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1341 CONGRESS AVE Owner WILLIAM D /DORIS JOHNSON JR Create Date 06/03/2011
Contractor BETTER HOME HEATING & AIR CONDII Category 501 - Residential -Air Conditioning Plan
Inspector John Zarate
Fuel 111 Gas J Oil Li Electric 1 Solar Solid
System n New 1 111 Replace 1 E] Other
J Forced Air J Radiant J Steam u A/C u Vent
J Electric (J Hot Water U Suppl. U Con. Burner
Chimney Type b Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss 0 As Approved O Existing • Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use /Nature SFR / INSTALL A/C, EIV SIGNED BY KOLLMAN ELECTRIC * *check 67961
of Work
Fees: Valuation $2,293.00 Plan Approval $0.00 Permit Fee Paid $44.50
Issued By: 25.M5....., Date 06/03/2011
El Permit Voided 1 Parcel Id # 1205240000
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 WI 5
P.O. Box
Oshkosh, WI 54903 -1130
(. 1111111 -2- )r
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
** Advisor - 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. f/
DATE r //
JOB ADDRESS / g � L . Qi -
OWNER , %'!/,/�� , �/ ' •
CONTRACTOR _ � iilu
CHECK gi ALL APPLICABLE
USA CATEGORY
E rF i I Sin 1e Famil ❑Du lex ❑Multi -Famil ❑Rental omm i ED.,
Family P Y
--LL MAY 2 6 2011
FUEL I3'6as DElectric ❑Solid SYSTEM ❑NeygEpARt P place
DOH ❑Solar CUMIN DEVELOPMENT
INSPECTION SERVICES DIVISION
TYPE
❑Forced Air DRadiant ❑Steam D /C ❑Vent DElectric DHot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B DDirect Vent ❑Other
HEAT LOSS DAs Approved DExisting ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value / /f
DESCRIPTION / SCOPE OF ALL WORK BIN9 DONE 2 ,t l� ( J4 &?1 J/42%r 7 tZ 4
/ ALPCA- •
VALUE (Including labor and materials) $ � c g(5 00
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 6—i41-0--
74' &- 9S9! 07/07
06/03/2011 00:41 9202737965 KOLLMANN ELECTRIC h PAGE 01/01
• City at Oshkosh
Division of Inspection Services
215 Churcb Avenue
PO Box 1 130
Oshkosh WI 54903.1130
Office 920- 236.5050
Fax 920. 236.5064
Electric Installation Verification
I (We) «awn F -!' c_ L L .
(Electrical � Contr / acttor Name � or Homeowner's Name)
(Address) ( ity) (State) (hip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
3 ,
(�
(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 Electrical
Contractor.
Other
The value of this work is S 7) .
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.
../1....44fir ALA.. _,. gC ✓°1n1 1/ 4 ‘
'' igna A f Company Officer or Homcowi1er) (rint Name) • (Date)
07)07
Received Time Jun. 3. 2011 1:34PM No. 5898