HomeMy WebLinkAbout0153495 - HVAC (replace furnace) CITY OF OSHKOSH No 153495
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1405 INDIGO DR Owner DAVID/PAULA SEILER Create Date 11/12/2012
Contractor A-1 HEATING&A/C INC Category 500-Residential-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel U Gas L Oil D Electric ❑ Solar ErSolid j
System [L New 1 g Replace ❑ Other
Forced Air ❑ Radiant ] ❑ Steam ❑ A/C ❑ Vent
❑ Electric ] ❑ Hot Water ❑ Suppl. ❑Con. Burner
Chimney Type • Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss 0 As Approved O Existing • Not Applicable 1 Value
BTU Rate i❑ As Per Plan O Variable • Other Value 60,000
Use/Nature SFR/REPLACE FURNACE, EIV SIGNED BY BELL ELECTRIC **check#11745
of Work
Fees: Valuation $1,417.00 Plan Approval $0.00 Permit Fee Paid $32.50
Issued By: Irrill Li. Date 11/12/2012
❑ Permit Voided J Parcel Id#1307310100
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 W8078 HILLCREST CT HORTONVILLE WI 54944 -9301 Telephone Number 920-779-8838
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.
9191 '°N lAVl :OI 6[06 'ZL 'n0N aL1 J pania°q
City of
11111C1911''41111r.
Division o
on of Inspection Services
P.O_Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084
4 P1THE'Weir N
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$100.00 plus the
normal permit fee,which ever is greater.
OR
I ou are a contractor •artici,atin_ in the Per, it ee Account S stem and have ade,uate unds check here
if you want this prQcessedJhrough your account [1
**Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
'with the permit application. Applications submitted without an ETV when such is required,will not be
/ processed for Permit Issuance and will be retuned for completion.
DATE
JOB ADDRESS 110 S-- "5 c r—
OWNER ,v e.. S 1 -
CONTRACTOR _ _
P.O.Box 311
CHECK®ALL APPLICABLE Hortonville,WI54944
USEIATEGORY
108 ,rie Family DDuplex ❑Multi Family DRental ❑Commercial ❑Industrial
FUEL EIk ❑Electric ❑Solid SYSTEM ❑New ❑Replace
• ❑Oil 0 Solar °Other
TYP
orced Air DRadiant OSteam ❑A/C DVent ❑Electric ❑Hot Water ❑SuppL °Con. Burner
IS CHIMNEY BEING LINED 13ldo DYes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented. n
CHIMNEY TYPE DChimney A LlChimney B ❑Direct Vent l er I"tC
HEAT LOSS DAs Approved ItKxisting ON t plicable
BTU RATE ❑As Per Plan ❑Variable ! .;Pal 01 (fit) e.)
DESCRIPTION/SCOPE OF ALL WORK BEING DONE_ c%ri2-.2 (�. ce t>n...0.� -
aa 1 q l
VALUE(Including labor and materials)$ Y (4 (-7 f
$.3zsb
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
I
07/07
TO/I0 39t1d 9NIld3H T t7 50696LL0ZbI LZ:Ot ZIOZ/ZI/TT
11/0//1012 WED 6: 34 FAX 920 733 2713 Watters Plumbing V1001/001
Cny orOshkosIi
DiY13101t of Inspection Services
Zr i Church Awax
?O 8o%1130
�. �� Usrritt„h WI S490y O17Q •
Orllct 9(0.236.3030
E.* 020.736-sO9i
Electric installation Verification
•
I (We) •... LFC' 'r' [.
•
(Electrical Contractor Name)
Po. 11 F 064446 4./d 5'51952.
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for 4--1 H #oily
G1N Ste: t - to)
(Name of patty contracted to}
9 o -a�a l08,
gibe je following address:
•
(Address where work will be performed)
•
•
The nature of the work consists of: (Check One or Describe the Nature of Work)
_/Reconnection or new circuit for replacement Heating Plant and/or AIC Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter lox, alterations to receptacles
and lighting fixtures due to siding/soffit installation. Note: New Service
Entrance Cables will require a separate permit. •
Reconnection or new circuit for the replacement of other permanently wired
appliances/fixtures.
New circuit for the addition of A/C to an individual dwelling unit(house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is$
1 hereby verify y this work will he performer( by an employee of this company and further verify
the reconnection /installation will be done in compliance with manufacturet.nnd Electric code
requirements.
-6//e/Afc)
tG _1112.1L,'1
{ gnottire. o 1 Company Officer) (Print Name of Officer) (Date)
TO/T0 BEd SNI.Lb3H T V 50696LLOZ61 LE:LT ZIOZ/9O/TL
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