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Home My WebLink About0155700-HVAC (boiler) � CITY OF OSHKOSH No 155700 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 14 E NEVADA AVE Owner BRUCE M/ROSEMARY SAMMONS REV TF Create Date 05/17/2013 Contractor ALANNE CLIMATE CONTROL LLC Category 500-Residentiaf-Heating&Ventilating Plan Inspector John Zarate Fuel ✓ Gas Oil Electric--� Solar Solid System � New _J a Replace � � Other I : Forced Air Radiant Steam A!C Vent Electric ✓ Hot Water Suppl. Con. Burner I : Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable Heat Loss As Approved � Existing � Not Applicable Value BTU Rate As Per Plan � Variable � Other Value Use/Nature Replace existing boiler of Work Fees: Valuation _ $2,000.00 Plan Approval _ $0.00 Permit Fee Paid $30.00 Issued By: Date 05/17/2013 ❑ Permit Voided � Parcel Id#1505540000 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 sec necessa s efore starting such activity. Signature �-,,. Date J�/�/3 AgenUOwner Address 2971 SUNSET POINT LN OSHKOSH WI 54904 -1008 Telephone Number (920)312-1228 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 54903-1130 Phone(920)236-5050 Fa�c (920)236-5084 Of HKO.IH 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 l 128, Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR If vou are a contractor participating in the Permit fee Account Svstem and have adeguate funds, check here if vou want this processed through vozrr account n **Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted with the permit application. Applications snbmitted without an EIV when such is required, will not be processed for Permit Issnance and will be returned for completion. DATE � " ��~ I-5 JOB ADDRESS I�{ t`.- ��'�1�J�,' OWNER 1��I I �� ` ,�✓�-ti��L��_� CONTRACTOR �t!y(�►,(Ul5 �l,4►'►7 6a�L' ��•.�� CHECK�ALL APPLICABLE USE CATEGORY BSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL C�Zias ❑Electric ❑Solid SYSTEM ❑New ❑Replace ❑Oil ❑Solar ❑Other TYPE ❑Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric 0frt Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANLJFACTURER Note:All chimneys shall be sized per the BTU's being vented. : CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value DESCRIPTION/SCOPE OF ALL WORK BEING DONE f��;n4� ,�'s�i.,i�� VALUE(Including labor and materials)$ 2,�� ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) y(jv,2� ��SK-�� a�/o� y 1713 02:41 p Yourr Electric Uc 9207794439 p.1 � c;ty orasm:o.� � Divisionoflnspecti•�nServices 2l5 Charc6 Avenuc POBox I1?0 Oshkash R7 54903-I130 K OfSce 920-236-5050 .n n'wn-ec Fax 920-�G5084 Electric Installation Verification � I (We) � 1� t.._°C � . �� : (Electrical Contractor Name or Homeowner's Name) ��, ��,� �� /� �,.� .��-��/ (Address) (City) (State) (Zip Code} accept the responsibility Eo perform the electric work as stated belou�, at the following address: � .�� 1��t.G��t s�' (Address where work will be perfarmed) The nature of the work consists of: (Check One or Describe the Nature of V✓ork) �Reconnection or new circuit for replacement Heating Plant and/or A./C Gondenser. Reconaection or new circuit for replacement Electric V��ater Heater or power vented water heater. Reconnection of the Sen�ice Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding,'soffit installation. Note: New Service Entrance Cables u�ill 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, including required service electrical outlets. 1lrote: Homeowners can only do their own electric on a si�cgle family ox-�ner occupied home. YY'ork on a condominiu�n, duplex, rental, or multi-use building would require a licensed Eleclrical Contractor. Other The value of tlus work is $ S I �O I hereby verify this work�rill be performed in compliance wlth the License requirements of Secrion 11-22 of the Oshkosh lvlunicipal code and further verify the reconnection/installarion �vill be done in compliance ti�zth manufacturer and Electric code requirements. c ♦ ' � ' �' S .5� � .3 {Sign e of Company Officer or�omeowner} (Print Name� �D � 0%/0;