HomeMy WebLinkAbout0159138-HVAC (furance) � CITY OF OSHKOSH No 159138
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1214 W NEW YORK AVE Owner CHRISTIE LAUNIUS/SUSAN M RENSING Create Date 12/23/2013
Contractor E C MERRILL INC Category 500-Residential-Heating&Ventilating Plan
; Inspector John Zarete
Fuel ✓ Gas Oil � Electric �' Solar Solid `
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System � New I �✓ Replace � Other I
✓ Forced Air ` �Radiant � Steam _J A/C ' Vent �
Electric Hot Water Suppl. _� Con. Burner �
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable
Heat Loss As Approved � Existing _ � Not Applicable Value
BTU Rate As Per Plan 0 Variable � Other Value
Use/Nature SFR/Replace existing furnace with Coleman model
of Work ,
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Fees: Valuation $3,900.00 Plan Approval $0.00 Permit Fee Paid $78.00
Issued By: �7 Date 12/23/2013
❑ Permit Voided I Parcel Id#1205920000
In the perFormance of this work, I agree to perForm all work pursuant to rules goveming 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 activiry.
Signature Date
AgenUOwner
Address 809 WISCONSIN AVE FOND DU LAC WI 54937 -2702 Telephone Number (920)235-3600
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 speci�ed 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.
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City of Oshkosh `
Division ofinspection Ser��icz� � �
� P.O. Box l l30 � �
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Oshkosh, WI 5490.i-1130 �
Phone(920)236-5050 `
Fax (920)2.i6-5084 Of HKOlH
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HVAC PERMIT APPLICATION
� _all i;�=�-�--_::�._-. __�-�,.�_� ,�::�_��-i.� �lust be provided.
I;�:��. ..: -. . ..�:::,�_ •,;;;' ^:o:�e processed.
� • Application(s) and fee(s) can be brou=llt to Cit� Hall, Room �0� or mailed to I��spection Services, PO Box 1128,
� Oshkosh �l�I �-1903-1128. Commencina ���ork���ithout pennit(s) ��ill result in fees being doubled or$100.00 plus the
normal pennit fee. «hich e�er is Qreater.
OR
If vou are a contrnctor participatrn� in the Permit�ee Account Sl•stem and hare adequate funds check here
if vou war7t tlris processed th�•otrah vour 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 submitted
with the permit application. Applications submitted without an EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE /O�Jf3
JOB ADDRESS I���,�. E� yO��C' �-r!/6 •
O«'\ER C;1�1���S7lE �,�1N�G�S
CO\TRACTOR �, �. �E�Z,�/GL �il/L''•
CHECK H ALL :�PPLICABLE
USE CATEGORY
� C�Single Famil�- ❑Duplex ❑Multi-Famil�� ❑Rental ❑Commercial ❑Industrial
� FUEL f�Gas ❑Electric ❑Solid SYSTEM ❑New J�Replace
❑Oil ❑Solar ❑Other �
TYPE
�Forced Air ❑Radiant ❑Steam ❑A1C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHI'VT�"EY BEI\G LINED ��o ❑Yes - L1NER SIZE & MANUFACTURER �
Note: All chinme�s shall be sized per the BTL�s beina vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑E�istinQ ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTIO�/SCOPE OF ALL WORK BEING DONE
JP�'`,o�E EX�S�iNC, �i,c�.ria�E �vrr�r �o��n��/ �rr��z : �"i�9do�o
�d,oaa ��y a S r�4G�� �/a�i,a�scE .S��o •
VALUE (Including labor and materials) $ 3� �O�•0 Z/ ��2/��`� 7�'�
✓ ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) �jf�f�jy,(/� �zJ,�LC�
o�/o�
11I1912013 10:56 9202737965 KOLLMANN ELECTRIC PAGE 02/02 �
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Divir,ic,n of le�eoriot�34rvices
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Electric In�tal�a#�o� Verifieation
I(We) � � s� ,.- ��� r ` � � .�"
(�I�ctrioal Can�ract�r i�iam:e or Homeowner's itiame)
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(Addt�ess) (Ciry) (5€at�� (Zig�ade) �
�cc�pc the xesponsibility to,perform Y.iRe eie�ctric a��ark as �ta�d below, at r:�c�oilov►�irtg address:
a, � Il�� `�O�-� ��e.
(Address wh�ce work will be per�c�raied)
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T'�nature of the wosk con�ists of: (C��c�C�riC OF I,�eSCri.�JC I�e�A��Pt�VQik3 #
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�„�„ Reconnect�an or�ew ci�cuit fox replacemenz�.ear�g Pl�u aud/or�'C Cond�nser. �
£t�cannection or aew circtut foz�re�l�cement Electric W�t�r�-Iea#;er ox pow�r v�nted
�� wa�en c�ator,
Recpunectio�i�f�he Ser�iGe Entranc�Cab1e,��.eter Box,ait�ratic�n�ta r�cept�cle.s
ar►d li�h.ting fixtures duc to szd�ng; soffit instaliation. �iate: New Sezvic�
Ent�ce Cables wsll ze�uire a sep�►te perm�t. �� wired
Recontuct�on�x new circuit fot the �eplae�ment of otha�per�� Y
apptiauc�s/f�ctuz�s.
� Ivew ci,rcuit�or the sddition of A/C tn an irrdividual dwelYS gar�anl dout�own
required ser�ce electri�$1 outl�ts, Aiote: I�'om�ow►�
electric flrc a singFe family o�unsr o�cupied hc�me.r�aalicerised Ele��Q-urn�
duplex, rental, or mrulti-use buiFdfng wo�cld r�qu
Contractor.
� Qt�ier �
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The valu� of this r�vark is � ,�
rxorzs�ed 'zn c�mg,tiaacc with the Lio�r,s�e�equireme�ta of
i�ere�y ve�cify this wor.k will be� ,
Sec�ioa 1 I-22 nf t�ze Osh�ash Ariwaicipal.code and��c o.�de�ew,�r��a�n I in�t�li�tiou
vv� b�doz�e iri campTiance witb,nanvfaan�rer ac2d :
� �� ���/'y� � (rrra�+n ' I I'�f"a/�
�t�`'�'�+�'r {Dat�}
of Gomp�+b��er or�omao^wncr) (pr�t*_�tamc)
�$�� n7�0?
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