HomeMy WebLinkAbout0146621-HVAC (a/c) 0 CITY OF OSHKOSH No 146621
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1324 W 9TH AVE Owner JEFFREY S /LUAN K PETERSON Create Date 06/30/2011
Contractor MARTENS HEATING & COOLING Category 501 - Residential -Air Conditioning Plan
Inspector Nicole Krahn
Fuel j Gas LJ Oil L) Electric Li Solar U Solid
System 0 New ❑ Replace 1 [] Other
L Forced Air Li Radiant Li Steam j A/C L Vent
Li Electric U Hot Water U Suppl. U Con. Burner
Chimney Type 0 Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss p As Approved O Existing • Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use /Nature SFR / Install new central air. EIV signed by Ace Electrical Services. * *debit acct
of Work
Fees: Valuation $5,798.00 Plan Approval $0.00 Permit Fee Paid $97.00
Issued By: Date 06/30/2011
E] Permit Voided I Parcel Id # 0608560000
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 PO BOX 514 OMRO WI 54963 - 514 Telephone Number 920 - 685 -0111
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 OJHKOJH
ON THE WATER
HVAC PER'MIT 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
Ifvou are a contractor participatine in the Permit f e Account System and have adequate funds. check here
if you want this processed through your account
DATE a y- i I
JOB ADDRESS 1 3R `7 s '. O - \(.ci h 5 i/ goa
OWNER J e C' PL VSl
CONTRACTOR I"1 a r-1-r r t�k i f l n
CHECK H ALL APPLICABLE
U E CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ❑Electric ❑Solid SYSTEMTew ❑Replace
❑Oil ❑Solar ❑ ther
TYPE
❑Forced Air ❑Radiant ❑SteammA/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINEDo ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per a 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 OF ALL WORK BEING DONE
1 115i p ing C 'r* a (1 r - -
VALUE (Including labor and all materials including light fixtures) $ 5 ; �7 `9 8 -co - l q 7'
ELECTRICAL CONTRACTOR OR )(Electric installation Verification form attached(lf Replacement)
Elec installation of new /replacement equipment shall be done by licensed contractors
3/02
City of Oshkosh
Division ofinspecUon Semmes
215 Chuech Avenue
PO Boa 1130
( /(J Oshkosh WI 5 4902 -1130
0,./1_ E WATER ! office 920. 236.5050
Fax 920 - 236 -5084
Electric Installation Verification
(I) MO 4 iA l - ei t t °S Ii" )1/ qi-i& Ai- (Electrical Con o Sc�' +cC for Name) �2r t- -c,
- s ue,
(Address) — (City) (State) ��
State) (Zip Code)
have been contracted to perform electric installation work for ielP Pcicr_scr) ,
(Name of pasty contracted to)
at the following address : h S
v ' . 5
(Address where work will be performed)
The nature of the work consists of : (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, alt
lighting fixtures due to siding / soffit ' � to receptacles and
Cables will r g la °n. Note: New Service Entrance
. require a separate pennit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $ ° 2�
I hereby verify this work will be
reconnection /installation will be do a i com pliance with manufacturer company
and further verify the
requirements. ufttrer and Electric code
(Signature of mpany Officer) ....._., ,,,, " ,-?''' / if i _
�
(Print Name of Officer) (Date)