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HomeMy WebLinkAbout0151966 - HVAC (Replace Furnace) 0 CITY OF OSHKOSH No 151966 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1020 BALDWIN AVE Owner THOMAS G/JANET L WASHATKA Create Date 08/27/2012 Contractor MODERN SHEET METAL INC Category 500-Residential-Heating&Ventilating Plan Inspector John Zarate Fuel ✓ Gas Li Oil ] [- Electric I LSolar j Solid System ❑ New 0 Replace I Ll Other u Forced Air J Radiant J Steam I LI A/C _ Vent L Electric u Hot Water I_ Suppl. 1 1 L Con. Burner 1 Chimney Type 0 Chimney A • Chimney B 0 Direct Vent 0 Not Applicable Heat Loss 0 As Approved 0 Existing • Not Applicable Value BTU Rate 0 As Per Plan 0 Variable 0 Other Value 60,000 Use/Nature SFR/REPLACE EXISTING FURNACE,EIV SIGNED BY TWINS ELECTRIC **check#9043 of Work Fees: Valuation 4,000.00 Plan Approval $0.00 Permit Fee Paid $70.00 Issued By: 3-rn Date 08/27/2012 ❑ Permit Voided Parcel Id#1109960000 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 2180 AMERICAN DR NEENAH WI 54956 -0 Telephone Number (920)733-4713 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 OJHKKJH 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$100.00 plus the normal permit fee,which ever is greater. OR If you are a contractor participating in the Permit fee Account System and have adequate funds, check here if you want this processed through your account n **Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an ELY when such is required, will not be processed for Permit Issuance and will be returned for completion. DATE D� JOB ADDRESS / GRD alk/4.-1111>) OWNER_ 712,-)/ CONTRACTOR_22#7/Ju ∎� /// AUG 2 7 2012 DEPARTMENT OF COMMUNITY DEVELOPMENT CHECK®ALL APPLICABLE INSPECTION SERVICES DIVISION USE CATEGORY ❑Single Family ❑Duplex ❑Multi-Family ❑Rental El Commercial ❑Industrial • FUEL . -. ❑Electric ❑Solid SYSTEM ❑New kw place d Oil DSolar DOther ' Eced Air ❑Radiant ❑Steam DA/C ❑Vent DElectric ❑Hot Water ❑Suppl. DCon. Burner fir CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANUFACTURER Note:All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A Chimney B ❑Direct Vent DOther HEAT LOSS DAs Approved DExisting ❑Not Applicable �,,9t.��^'"�� BTU RATE DAs Per Plan DVariable DOther Value 2 /0 4 DESC ION I SCOPE OF ALL WORK BEING DONE Mee— (7-0,2/4,i.:0/1 s7 �,[i1.h.LLCe_._ 12- st-2 V VALUE(Including labor and materials)$ 957:.9r,9_3 ELECTRICAL CONTRACTOR(for projects not r e ' quiring an 4Y`t7' ^ EIV Form)-6 6D ah C * 25-t = '10,0 / V FGJ12/Pt—J V.14I etc), o 07/07 City of Oshkosh Division of hupeclion services 21$Church Avenue PO Box 1130 Os6tosh WI 54903-1130 Office 920-236-3050 z w Fax 920-236-50E4 II Electric Installation Verification T(W /7 se) (Electrical Contractor Name pr Homeowner's Name) 1 91,3`7 (-f, -A7,1e--fin vU 51/qIS (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below,at the following address: /020 2ki,� �dV OA" , k4 5490/ . ( where re)work w ill be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser. Reconnection or new circuit for replacer cent Electric Water Heater or power vented water heater. Reconnection of the Service Entrance C ble,Meter Box,alterations to receptacles and lighting fixtures due to siding/soffit installation. Note: New Service Entrance Cables will require a separate permit. Reconnection or new circuit for the replacement of other permanently wired ., / appliances/fixtures. V New circuit for the addition of A/C to an individual dwelling unit, including required service electrical outlets. Note: Homeowners can only do their own electric on a single family owner occupied home. Work on a condominium, duplex, rental, or multi-use buildingwould require a licensed Electrical Contractor. Other The value of this work is$ _g6 9 ©0 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 e lone ••mpli: - ith manufacturer and Electric code requirements. \bieW - i W6- ( ignatureof Company Office j omeowner) (Print Name) (Date) 07/07