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Home My WebLink About0151527 - HVAC (install AC) (9 CITY OF OSHKOSH No 151527 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1264 BAY SHORE DR Owner SERGE!A/SARA N KOSSOLAPOV Create Date 08/03/2012 Contractor THOMPSON HEATING AND COOLING S Category 501 -Residential-Air Conditioning Plan Inspector John Zarate Fuel Li Gas Oil Electric j System Q New I--� Solar 1 I I Solid ❑ Replace ❑ Other j LI Forced Air -1 u Radiant ❑ Steam ,i A/C I Hi Vent Electric J ❑ Hot Water j 1 j Suppl. Li Con.Burner Chimney Type p 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 O Variable • Other Value Use/Nature SFR/INSTALL NEW A/C,EIV SIGNED BY T RUCK ELECTRIC **check#2921 of Work Fees: Valuation $1,800.00 Plan Approval $0.00 � �� Permit Fee Paid $37.00 Issued By: J 1 Date 08/03/2012 ❑ Permit Voided i Parcel Id#0804230000 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 901 OTTER AVE OSHKOSH WI 54901 -5444 Telephone Number 920-426-3095 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 OfHKOIH 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 **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 ETV when such is required, will not be processed for Permit Issuance and will be returned for completion. DATE ;0.03- JOB ADDRESS 1/11/ OWNER CONTRACTOR '771-0 a�nsn?' t-1--&347-7/ Y CHECK H ALL APPLICABLE USE CATEGORY Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL El Gas ❑Electric ❑Solid SYSTEM 11' New DReplace 00i1 ❑Solar ❑Other TYPE ❑Forced Air DRadiant ❑Steam 0A/C ❑Vent DElectric DHot Water ❑Suppl. DCon. 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 DOther Value DESCRIPTION I SCOPE OF ALL WORK BEING DONE 40 ..4/ VALUE (Including labor and materials) $ /tC� • er? ELECTRICAL CONTRACTOR(for projects not requiring an EIY Form) 07/07 City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh WI el`align Office 920-236-5050 54903-1130 •N WA Fax 920.236-5084 Electric Installation Verification I(We) - ' r _ ► �_ (Electra al Con.actor Name or Homeowner's ► -..e) (Address) �� ' t— .. 'w ' - S C)Z_ (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: 6,1 (Address where work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) l/'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$ 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 bed on- in compliance with manufacturer and Electric code requirements, // (Signa • of Company 0 iceomeowner) (Print Name) l7 (Date) 07107