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Home My WebLink About0153738 - HVAC (new gas svc) 0 CITY OF OSHKOSH No 153738 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 180-190 S WESTFIELD ST Owner BRUCE J GURSKE Create Date 11/28/2012 Contractor OWNER Category 500-Residential-Heating&Ventilating Plan Inspector Nicole Krahn Fuel U Gas ❑ Oil - Electric j Solar _ 1 LIFDTid System 0 New ❑ Replace ❑ Other ❑ Forced Air I H Radiant j Steam A/C Vent ❑ Electric 1_1 Hot Water 0 Suppl. Li Con. Burner I Chimney Type ❑ Chimney A 0 Chimney B • Direct Vent 0 Not Applicable Heat Loss ❑ As Approved 0 Existing • Not Applicable Value BTU Rate 0 As Per Plan 0 Variable • Other 1 Value Use/Nature DUPLEX/installation of new gas service to operate two new free standing stoves/all work will meet local and state codes/air test on of Work gas piping per code/gas piping has been grounded by Beez Electric Fees: Valuation $4,200.00 Plan Approval _ $0.00 Permit Fee Paid $73.00 Issued By: Z(--. Date 11/28/2012 ❑ Permit Voided Parcel Id#0615090000 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 -= ement,the • strongly urges the permit applicant to contact the easement holder(s)and to secur �nyy necessary pre - 'befor- -• ng such activity. �p Signature -secur ` e / Date /GO 260--- OAgent/Owner Address OSHKOSH WI 54901 -0 Telephone Number 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 1 130 Oshkosh,WI 54903-1130 Phone(920)236-5050 Fax (920)236-5084 Oil KO JH ON THE ',NAT R 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$100.00 plus the normal permit fee, which ever is greater. OR If you are a contractor participating in the Permit fee Account System and have adequate funds, check here if you want this processed through your account [i **Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. r_ DATE g' NO 2 L z JOB ADDRESS Igo- Igo S 4, WEST l'lkid OWNER UCCA,. T C-0 k'S fS e CONTRACTOR CHECK l ALL APPLICABLE USE CATEGORY ❑Single Family Duplex Multi-Family 11JRental ❑Commercial ❑Industrial FUEL ( Gas DElectric ❑Solid SYSTEM <New DReplace ❑Oil ❑Solar DOther TYPE OForced Air DRadiant ❑Steam ❑A/C ❑Vent DElectric DHot Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B Direct Vent DOther HEAT LOSS DAs Approved ❑Existing ❑Not Applicable BTU RATE DAs Per Plan ❑Variable DOther Value DESCRIPTION/SCOPE OF ALL WORK BEING DONE 7 Je i 9 1AI5/o nstho u 7` J s-�ove, s c, Zit( l �.� 5 VALUE (Including labor and materials)$ 7 b C °- S'-r°0 L-S ) kL 136,°° F 4/vG f fo {dJ2i. ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) �EC Z• t c7/07 ity of Oshkosh Division of Inspection Services 215 Church Avenue 'u*"om Oshkosh WI 54903-130 Office acz �ma/ --.�..�.c�� ' s` 92o-2m'mm Electric Installation Verification (I) (We) Becz Electric, Inc. 1901 Osborn Ave Oshkosh V0 54902 have been contracted to perform electric installation work for Bruce Gurske, at the following address: Bruce Gurske 190 S. Westfield Oshkosh, YVi 54902. 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 ' | | Reconnection of the Service Entrance Cable, Meter Box, alteration 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 other permanently wired appliances / tixtures. Other Bondingof gay }iuc. The value of this work is $245.00 I hereby verify this work will be performed by an employee of this company and further verify the reconnection/installation will ho done iu compliance with manufacturer and Electric uwJc requirements. �� (Sig atufe of Compan Officer)