HomeMy WebLinkAbout0146992-HVAC (furnace & a/c) Cli) CITY OF OSHKOSH No 146992
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 426 AMHERST AVE Owner JAMES THOMA Create Date 07/27/2011
Contractor BERLIN HEATING & COOLING Category 502 - Residential -Both Plan
Inspector John Zarate
Fuel 121 Gas J Oil 1 Electric U Solar 1 Solid
System ❑ New 1 0 Replace 1 ❑ Other
u Forced Air J Radiant J Steam u NC Li Vent
Li Electric Li Hot Water LL Suppl. Li Con. Burner
Chimney Type 10 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other 1 Value 100,000
Use /Nature SFR / REPLACE FURNACE AND A/C, EIV SIGNED BY ECS ** check #2441
of Work
Fees: Valuation $5,300.00 Plan Approval $0.00 Permit Fe Paid $89.50
Issued By: F5Yr1 Date 07/27/2011
❑ Permit Voided Parcel Id # 0701960000
In the performance of this work, I agree to perform all work pursuant to rules governing the described con truction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if yo perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to con act 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 Telep one 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 prc}ject 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 1T��
R o.-�. p
HVAC PERMIT APPLICATION
All information after bold categories must be provided. JUL 1 4 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 Inspecticia ii WIRI281VT
Oshkosh WI 54903 -1128. Commencing work without permits) will result in feestieffiediirtilikani00530011islObi
normal permit fee, which ever is greater.
OR
If vou are a contractor partigivating in the Permit fee Account System and have adequate funds. check here
if vou want this processed through your account (—(
** 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) mast 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 7 1 / — l
JOB ADDRESS 1 1 �� 4 h�r-�t / cJ�✓tue_
OWNER S o �a
CONTRACTOR 3c — ti-e affr.q $, I � a D .i. o � � e afi,•� $ Co � )
�J �J J �
CHECK ® ALL APPLICABLE
4 5, CATEGORY
ingle Family DDuplex DMulti- Family Mental DCommercial DIndustrial
FUEL as DElectric DSolid SYSTEM DNew Allreplace
DOiI DSolar DO
F TYPE
orced Air DRadiant DSteamA/C DVent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED o DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A DChimney B r erect Vent DOther
HEAT LOSS DAs Approved DExisting ;,bt Applicable
BTU RATE DAs Per Plan DVariable ,Other Value /oo, r r C
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
VALUE (Including labor and materials) $ S 3 Qp
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) it/i J e.a r !- e_("
07/07
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903 -1130
O f HKO, f I I Office 920 - 236 -5050
ON THE WATER Fax 920 - 236 -5084
Electric Installation Verification
I (We) L C
(Electrical Contractor Name or Homeowner's Name)
fD igox 5 ws 5 23
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
144 144x/.,. -s
(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 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 $ OLP
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.
/VacFP -v '2424. /t
(Signature of Company Officer or Homeowner) (Print Name) (Date)
07/07