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HomeMy WebLinkAbout0153252 0 HVAC (replace furnace/AC) 10 CITY OF OSHKOSH No 153252 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1421 LAWNDALE ST Owner JACK R/BETH A SICKINGER Create Date 10/30/2012 Contractor BLACK-HAAK HEATING Category 502-Residential-Both Plan Inspector John Zarate Fuel 0 Gas Erbil 1 Electric D Solar Solid System ❑ New J 0 Replace ❑ Other Forced Air 0 Radiant ❑ Steam U A/C Vent I Electric 1 ❑ Hot Water _, luppl. ❑Con. Burner Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • Not Applicable Heat Loss 0 As Apved 0 Existing pro • Not Applicable 1 Value BTU Rate ❑ As Per Plan O Variable • Other Value Use/Nature SFR/REPLACE FURNACE AND NC, EIV SIGNED BY KRUEGER ELECTRIC **check#2673 of Work Fees: Valuation $8,000.00 Plan Approval $0.00 Permit Fee Paid $131.50 Issued By: n(.-J Date 10/30/2012 ❑ Permit Voided_, Parcel Id#1513980000 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 PO BOX 7075 APPLETON WI 54912 -7075 Telephone Number 920-757-9990 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 D 04 2 Inspection Division o on of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone(920)236-5050 Of KOJH Fax (920))236-5084 r-r'c'7TFi 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 5100.00 plus the normal permit fee, which ever is greater. If you are a contractor ctor participating in the Permit fee .1ccount System and have adequate funds, check here if you want this processed through your account Ft ** 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 EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. DATE 10-- 96-1 a JOB ADDRESS PIA 1 1- 40ni 11t k c iiVED OWNER jack # Be* 61C in r REC . , CONTRACTOR blade- fiaakr ,r/it'y .rile. - OCT 3 J 2012 // O CHECK © ALL APPLICABLE COMMUNITY DEVELOPMENT INSPECTION SERVICES 'DIVISION USjit CATEGORY 'Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL PI'Gas ❑Electric DSolid SYSTEM ❑New Kit eplace DOil ❑Solar ❑Other TYP orced Air ❑Radiant ❑Steamm /C ❑Vent ❑Electric DHot Water ❑Suppl. ElCon. Burner IS CHIMNEY BEING LINED P'<o ❑Yes - LINER SIZE N 0 & 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 ElExisting ❑Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value f DESCRIPTION /SCOPE OF ALL WORK BEING DONE Ariet tQjn¢.�Ti t?1 e:t.S �ki�I`1C[de an a,i✓ C/JylGIi r J VALUE (Including labor and materials) $ D, Oyu ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) age/ z--&er ,c Clry rrf 017,1 nM 4410, LVtiasnxr rrf lart.e nan 211 c•h„R,h PU Bo.100 0,1-Ankh WI 54V-01.1I 3C 0J1-K fH Oinv 17A S,ISU W+7..6._7..rr I, Pk& 420.21M1 30/14 Electric Installation Verification (r) (We) __.. C�a ra v E - ( ctrical Contractor Name) ! U'_ c r�cY Ca n. f o C" �� �' � L 7/1 /� l.-L,.��`-C_ (Adds) (City) (State) (Zip Code) have been contracted to perform electric inirallauon work for , 1aek-H %j (Blame of party contract 1 to) at the following addre e: I kAi,t:Ylr'a 1 c9 (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 AJC. Condenser. Reconnection or new circuit for replacement Elee ric Water Heater. Reconnection of the Service Entrance Cable, Meter Box, alterations to receptad m and lighting fixtures due to siding soft installation, Note New Service Entrance Cab lea will require a separate permit. Reconnection or new circuit for otherpermanerttly.wired appliances / fixtures. Other The value of this work is s_150- I hereby verify this work will be performed by an employee of this company and further verify the reconnection: installation will be done in compliance with manufacturer and Electric code requirements. 6)..f (5i P�atuJ c of Com P Officer)y (J'nnt Name of Offic.or (Date.) F1.1 %.666L'nLt3 6 11j:6t