HomeMy WebLinkAbout2012-HVAC (replace furnace) CI) CITY OF OSHKOSH
No 153449
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Owner LAURA L BERKEBILL Create Date 11/08/2012
Job Address 620 SCHOOLAVE —
Contractor MARTENS HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate --_ - — Solid
S
J
Gas i ❑ Oil 0—Electric� ] D Solar 1 Li
Fuel ❑ —
_Replace Other
System ❑ New _ Q -----
y ✓❑Forced Air i Radiant 1 0-Stearn 1 ❑ NC _ 0-Vent
❑ Electric 7 [T
Hot Water ] i f Suppl. ] ❑ Con.Burner-1
Chimney Type ❑ Chimney A ❑ Chimney B • Direct Vent 0 Not Applicable J
Heat Loss ❑ As Approved ❑ Existing
• Not Applicable Value ——
— ——
O BTU Rate ❑ As Per Plan V � Other Value
Variable
UselNature SFR/REPLACE FURNACE **debit acct
i
of Work 1
Plan Approval $0.00 Permit Fee Paid $35.50
(3-in }Fees: Valuation $1,645.00 — —
Date 11/08/2012
Issued By:
❑ Permit Voided j Parcel Id#0201650000
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,t to contact ntace prform
eahemont
described in this permit application within an easement,the City strongly urges the permit applicant
holder(s)and to secure any necessary approvals before starting such activity.
Date
Signature
Agent/Owner
OMRO WI 54963 514 Telephone Number 920-685-01
11 11
Address PO BOX 514 __ - -
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.
11/08/2012 09:46 9206850490 MARTENS HEATING PAGE 01/02
City of Oshkosh
Division of Inspection Services .
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050 O���u
Fax (920)236-5084 I I
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 5490;4128. Commencing work without permit(a)will result in fees being doubled or 5100.00 plus the
normal permit fee,which ever is greater.
If you are a conntractorparticipatintin the Permit ee_Acc unt,Svstem and have adegyate funds, check here
ifyou want this processed thrpttgh_yQ.yr account H
DATE/1 -(2-
JOB ADDRESS 62-0 c14.00t tiQ _..
OWNER, Laura 13.Pr1 J2_14);( ■
CONTRACTOR ikrien 5' 4ga. Y `t- r'0' 1
CHECK H ALL APPLICABLE
US 4 ATEGORY
Ingle Family DDuplex OMulti-Family ❑Rental QComtnercial ❑Industrial
FUEL (r16- ❑Electric ❑Solid SYSTEM ONew ace
0011 DSolar ❑Other - -
eed Air ORadiant❑Steam❑AJC ❑Vent ❑Electric ❑Hot Water OSuppl.❑Con.Burner
IS CHIMNEY BEING LINED To AYes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented_ • •
CHIMNEY TYPE DChirnney A ❑Chvmney 33 �ct Vent ❑Otthher
HEAT LOSS DAs,Approved ❑Existing ONot Applicable
BTU RATE. DAs Per Plan ❑Variable ❑Other Value ,
DESCRIPTION OF ALL WORK BEING DONE ,Af 112., L MCP (APIA .
a 0
VALUE(Including labor and all materials including light fixtures)$ (CD Lb •
ELECTRICAL CONTRACTOR O leetrfe iostanstton Verification form atmehedpf Replacement)
Electrical installation of new/motormen:equipment shall be done by licensed comforters
Received Time Nov. 8. 2012 9: 09AM No. 1581 3/02
11/08/2012 09:52 9206850490 MARTENS HEATING PAGE 02/02
013,00111406
°t
ms „e Se�v�eec
PO Rex 2130
Oestikimb 9V1 54902-1130
Office n
o.. ,q warm! Pam 9 92D+4314E6o
Electric In a Verification
(7)(We) q✓ rt ;s
Mectrical Name) SC? ncC-s -6-4.
(Address) h'►x� W i 5119
(City) 404. (Zip Code)
have been Contracted to perform electric ikon work for •(Naga of{gty cantracted to)
at the followiAg ( )
(Address why wodc will be p rj)
The nanze of the work consists of: (Cheat One or Dom,the Nam of Work) •
Ramon or new circuit for replacement Heating Plant
Recortaection or acre cuvuit for repiasement El Condenser
lighting fixtures duc'hon of the Service E Ce Cable,Meta' 63 es and
Cables will requite a to aiding/soffit aeon, Nate: New Service
ReConnectiOti or rimy
separate permit
ocher cis other it for oer per 3,wired appitSIOCeS/ .
The value Of this work is$
I hereby verify this w T
ark will perfltamed by an
reconnection/installation will be done in employee of this company and firmer verify the
requirements_
with and Eixtric code
es
(Signature of •-•-•. Officer)) (Pry Name of Officer)
(Date)
Received Time Nov. 8. 2012 9: 14AM 1585