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Home My WebLink About0152249 - HVAC (replace furnance/AC) (1) CITY OF OSHKOSH No 152249 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 569 HAZEL ST Owner CYNTHIAA PAULICK Create Date 09/11/2012 Contractor E C MERRILL INC Category 502-Residential-Both Plan Inspector John Zarate Fuel ✓ Gas I f Oil Li Electric J Solar Solid System ✓ New 0 Replace _ ji [ Other J ✓ Forced Air Radiant Steam L ✓ A/C Vent ri-treCtric J _1 Hot Water ] U Suppl. J J Con. Burner Chimney Type Chimney A 0 Chimney B 0 Direct Vent • Not Applicable Heat Loss KJ As Approved 0 Existing • Not Applicable Value BTU Rate 0 As Per Plan 0 Variable • Other Value Use/Nature SFR/REPLACE FURANCE AND ADD A/C,EIV SIGNED BY KOLLMANN ELECTRIC **check#11623 of Work Fees: Valuation $6,300.00 Plan Approval $0.00 Permit Fee Paid $106.00 Issued By: �J Date 09/11/2012 ❑ Permit Voided Parcel Id#1103470000 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 809 WISCONSIN AVE FOND DU LAC WI 54937 -2702 Telephone Number (920)235-3600 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 154903-1130 � Phone (920)236-5050 Fax (920) 236-5084 Of-ICY I HVAC PERMIT APPLICATION ON THE unrr4 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 LLys.2u are a contractor participating in the Permit fee Account System and have adequate funds, check here !Lyon want this processed through your account ❑ 11�� DATE 1Y- 002- ---- -_ JOB ADDRESS S�lc /14eez �S7 OWNER (1/ 'i p f 4U2,(!/CONTRACTOR E< ,/�6'72,ei CHECK P'1 ALL APPLICABLE USE CATEGORY >�I Single Family ❑Duplex OMulti-Family ❑Rental ❑Commercial ❑Industrial FI EL f811Gas ❑Electric ❑Solid SYSTEM ( New 1 )Replace 0011 OSolar ❑Other TYPE KIForced Air ❑Radiant ❑Steam RAJC ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. 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 ❑Direct Vent DOther HEAT LOSS DAs Approved ❑Existing ❑Not Applicable BTIT RATE DAs Per Plan OVariable ❑Other Value DESCRIPTION OF ALL WORK BEING DONE /f ,fJ 4//e/U•Oi'e /l'0 10/21) A/r/eAL /Pie .0Nfl7/0e,v ie.t. , // P ®t(-6.6•� VALUE (Including labor and all materials including light fixtures) $ 4� od.OT� t79/Yt t'7- ELF C TR I CAL CONTRACTOR " ld//"51/W �LE?7',e/� X For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be attached. If not attached or not applicable, a separate Electrical Permit is required. 9/02 08/29/2012 05:01 9202737965 KOLLMANN ELECTRIC PAGE 01/01 City ofOehkoeh Divuian oflnspeaaon Services 215 Church Avenue PO Box 1 130 �t CTehhoeh W1 54903.1130 sya Kelm Otik 2024308050 Electric Installation Verification I (We) • • C4 r ' - L. .� (Electrical Contractor Name or Homeowner's Name) /' ) 'Ir s • (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: (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 1 soffit installation. Note: New Service Entrance Cables will require a separate permit. Reconnection or new circuit for the replacement of other permanently wired appliances I 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 eD The value of this work is S /OQ 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. /. - , ire , ,/Q/1 .. Sign= V-of Company Officer or Homeowner) (Print Name) (Date) 07/01 Received Time Aug. 29. 2012 5: 42PM No. 0669