HomeMy WebLinkAbout0104126 HOSHKOSH
ON THE WATER
.lob Address 1080 N WESTFIELD ST
Contractor MARX MECHANICAL
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner EVERGREEN RETIREMENT COMM INC
Category 500- Residential-Heating & Ventilating
L~ Electric
New ] ~] Replace ]
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~) Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~] As Per Plan ~] Variable ~ Other I Value
No
Create Date
Plan
~ Solid
104126
09/11/2003
Other ]
Vent
Use/Nature SFR/Replace furnace. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,800.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$47.00
Date 09/11/2003
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 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number
(920) 235-6510
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 t130
Osl~osh~ WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
Application(s) and fee(s) can be brought to City Hail, Room 205 or ma/led to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I i28. Commencing worx without peru-fit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
7£Vou are a contractor participatiny( in the Permit fee Account System and have adequate funds, chec]~ here
if you want this processed through your account [~
CHECK [] ALL APPLICABLE
USE CATEGORY
~l~Single Fmnily F'lDuplex
[2Multi-Family I-1Rental
I~commercial
lqlndustriat
FUEL l~Gas UlEIectr/c UlSolid SYSTEM 12tNew ~eplace
~Oit I~Solar UlOther
TYPE
~]Forced Air kJRadiant ~Steam ~A/C F1Vent UlElectric UIHot W~er UlSuppl. lqCon. Burner
is c mUN y aEING Lm-gD tnXo kn es , Ln'm S ZZ. __O_. & MANm 'acrur r k.
Note: Al! cb/srmeys shall be sized per the BTU s !;~fl~g Vented.
C HIxMNEY TYPE
ItEAT LOSS
BTU RATE
IqChimney A
[qAs Approved
UlAs Per Plan
D Chfirmey B
F1Existing
DVariable
U]Direct Vcnt
I~Not Applicable
IqOther Value
F1Other
DESClllPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ g~ ~ ~
ELECTRICAL CONTRACTOR ~
[] For applicable projects, an Electric~ - r,inOallation Verification form, signed by the Electrical ConkaGtor, lnust be
attached, lfn0t attacl~ed orn0t applicable, a separate Elect~'ical Permit ~s required. '
5/o2
Electric Installation Verification
(ir) (W~) Be~ Electdq,,,,Inc.
52J W, ]2th_ Ost!kosh ~_ 5490.__.~2
have been contracted to perform electric installation work for Marx Mechardcal,
at the following adckess: 10g0 N W~sttield St. Vfllaee #233,
The nature of the work consists of: (Check One or Desaibe the Nature of Work)
[] Recotaeetion or new ~ir~uit for r~placement Heating Pl~.t
K~oe~fion ~ new ~r~t f~ r~pla~ El~c Wtt~r
R~o~ec~en of~e S~ce ~r~ Cable, M~er Bo~
hg~ing ~u~s due ~ siflir~ / ~ffit ~lafio~ Nora: N~ S~ce Ent~ Cabl~
~ req~re a scp~te
Reco~e~ion or ne~ drcuit ~r ~her p~ntly ~r~
O~er
The value of this work is $t50,00
t h~eby verify this work will be performed by an employee o£tkls company a~d f~rther verify the
reeonne~tion / instal a~,oa unll be done in compliance w~ll~ maraffacturer
requkements,
(Signature of Company Off,er)