HomeMy WebLinkAbout0104354 HOSHKOSH
ON THE WATER
.lob Address 1827 MITCHELL ST
Contractor MARX MECHANICAL
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner MARVIN F/VERNA SUMMERVILLE
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
104354
09/23/2003
Other ]
Vent
Use/Nature SFR/Replace furnace with 70m btu. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$800.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$20.00
Date 09/23/2003
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.
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
(92o)236-5o84 , . O KO/H
HVAC PER~IT APPLICATaO~
All i*onmtion aX~r bold cat,aoXes m~i~E~y OF
incomplete applicatio~ will not g~?&~YY DEVELOPMENT
Application(s) and fee(s) can be brought to Ci~ Hall, Room 205 or mailed to h~spection Se~ice% PO Box 1128,
Os~osh WI 54903-I 128. Co~encing work without pe~i~s) will result in tees being doubled or $100.00 plus the
no~al pe~it fee, which ever is geater.
OR
7f ¥ou are a contractor participatine in the Permit fee ~ccount Y~stem and have adeguate funds, check here
if you Want this proce~ed throueh ~our account ~
DATE ~-~
CHECK [] ALL APPLICABLE
SE CATEGORY
ingle Fmnily IqDuplex nMulti-Family U]Rental E] Commercial FqLndustrial
FUEL ~[tGas []Electric [2Solid SYSTEM []New ~Replace
[] Oil [] solar []Other
TYPE
~Forced Air [Radiant []Steam []A/C []Vent DEIectric
IS CHI2VJ[NEY BEING LLN~sD [~No EYes - LI2qER SIZE
Note: All chinmeys shall be sized per the BTU's being vented.
[]Hot Water [Suppl.
& MANLrFACTURER
[]Con. Burner
CItlMNEY TYPE []Chinmey A []Chinmey B [2Direct Vent []Other
ItEAT LOSS ~As Approved ~Existing ~Not Applicable
BTU RATE []As Per PI~ ~V~iable UOth~ Value
DESCmPTION OF ~LL W9~ BEING DO~
VALUE (Including labor and all materials including light fixtures) $~7~/3/~) {_/(fl ,&)
EL CTmCA CO T CTO
[] For applicable projects, an Electric Installation Veril5 cation form, signed by the Electrical Coutractor, must be
attached, ffnot attached or not applicable, a separate Electrical Pennit is required.
9/02
· . 0~/2!/200~ i~:i8 9202317255 BEEZ ELECTRIO P~GE
Electric Installation Verification
B ~F_.lectric tne,
521W.12th O~hk. osh Wi 54902
heve been contracted to perform electric installa:ion work £or Marx Mechanical,
The nature of the work consists of: (Check One or D~cribe the Nature of Work)
[] l~.econnec6on or n~w tire. tit for replacement Heating Plant and/or A/C Condenser.
ReConnect/~n or new c/rc~t for replac~t Blectdc Warer Heater.
Reconnectlon of t~ Service Entr~lCe Cable, Meter Box, alterations to receptacles and
lightin~ tx'rares due to siding / soffit installation, l%te: N~w Service I~ntrtnc~ Cables
will require a separate permit.
[] R~cormection or llsw circuit for other perman~nt!y v~d appliances / fixtures.
[] Oth~
' ' 0
The value of this work ts $150.00
I hereby verify this work will be performed by an employee ofthi~ company and further verify the
recot~ectio~ / ~nstallation will be done tn compliance wth manufacturer and Electric
requirements.
(Signature of Company
~ 09.~/22/.0_3