HomeMy WebLinkAbout2011-HVAC (a/c) 0 CITY OF OSHKOSH No 146789
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1044 -1060 WITZEL AVE Owner CHAD M /CAROL J HURLEY Create Date 07/13/2011
Contractor BERLIN HEATING & COOLING Category 511 - Ind. & Comm -Air Conditioning Plan
Inspector
Fuel Gas U Oil Electric U Solar Li Solid
System n New 0 Replace I ❑ Other
Li Forced Air u Radiant ❑ Steam u A/C u Vent
Li Electric U Hot Water I 1 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 0 Other Value
Use /Nature CMC Laundry (1054) / Replace condensing unit on roof. EIV signed by Electrical Contracting Specialists.
of Work
Fees: Valuation $1,300.00 Plan Approval $0.00 Permit Fee Paid $29.50
Issued By: 0i7'y!/1/ Date 07/13/2011
❑ Permit Voided Parcel Id # 0609580000
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 134 QUARRY ST BERLIN WI 54923 - 0 Telephone Number 920 - 361 -3066
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 won Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 t��! � ��LJ�
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 Permit fee Account System and have adequate funds. check here
if you want this processed through vour account fl
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) foam, 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. -7
/ A DATE / " 20 t
JOB ADDRESS 1 S I L J - e ( /7 n G e
OWNER C /`'I C / L c1 .1dr�
CONTRACTOR 13€ — / e- i R., c g, co
CHECK ® ALL APPLICABLE
USE CATEGORY
❑Single Family °Duplex (]Multi- Family °Rental commercial [Industrial
FUEL ass DElectric OSolid SYSTEM (New Atlieplace
0011 DSolar DOther
TYPE
DForced Air DRadiant DSteam C °Vent DElectric DHot Water DSuppl. °Con. Burner
IS CHIMNEY BEING LINED ONo DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A DChimney B DDirect Vent DOther
HEAT LOSS DAs Approved DExisting °Not Applicable
BTU RATE DAs Per Plan DVariable °Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
1 ,- ac, ` �..dei s¢1 +Act- rol
VALUE (Including labor and materials) $ l �`�`� 42_
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) ! v J. 5 C z
dt a Ec S e(Qc_ -
07/07
12 11 04:02p ECS 9203611484 p.1
City of Oshkosh
Division oflnspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 549034130
Office 520.236 -5050
ON ri-ig I Fax 920. 236 -SO114
Electric Installation Verification
I (We) E Z, ,—f t ( -0►._ 4- r‘•- ( ---ti rs Sees;:. C; -c3 c.-LC
(Electrical Contractor Name or Homeowner's Name)
/l 67 r7 f-e-- R 4 Ri. ) lt.,s 5 z5
(Address) (City) (State) (Zip Code)
• accept the responsibility to perform the electric work as stated below, at the following address:
/ D S W 9 / 14-1.k.
(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 AIC 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 $ I 0 L) .
hereby verify this work will be performed in compliance with the License requirements of
Section 1. 1 - of the Oshkosh Municipal code and further verify the reconnection / installation '
will be done in compliance with manufacturer and Electric code requirements.
Ali i/,'e. Sz.Aar ? / / //i
(Signature of Company Officer or Homeowner) Print Name) (Date)
07/07
Received Time Jul, 12. 2011 3:51PM No. 6321