HomeMy WebLinkAbout0159142-HVAC (furance) t
� CITY OF OSHKOSH No 759142 �
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 742 W 9TH AVE Owner EMILY NEUSTIFTER Create Date 12/26/2013
Contractor DRUCKS PLUMBING&HEATING CO IN( Category 500-Residential-Heating 8�Ventilating Plan
Inspector John Zarate fi
Fuel ✓ Gas Oil � Electric � Solar Solid
System � New � �✓ Replace ' � Other
✓ Forced Air Radiant Steam A/C Vent �
Electric i Hot Water i 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 � Variable � Other � Value
Use/Nature SFR/replace furnace
of Work
'debit acct**
Fees: Valuation $3,350.00 Plan Approval $0.00 Permit Fee Paid $78.00
Issued By: �JW`�' Date 12/26/2013
❑ Permit Voided ' Parcel Id#0601460000
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
AgenbOwner
Address 314 APPLETON ST MENASHA WI 54952 -2318 Telephone Number 920-426-2654
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.
i
DEC-26-2013 08:41A FROM:DRUCKS PLL�IBINC C920)7zz-0651 T0:2365084 P.Z
City of Oshkosh .
Division of[nspection Services • . • �
P.O.Box 1130 �
Oshkash;WI54903-I130
Phone(920)236=5050
Fax (920)236-5084 IJI/ L�
f—II\ I�
. ON �a WATiR
HVAC PERMIT APPLICATION
All information after bold ca[egories 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 W[ 54903-1'128. Commencing work without permit(s)will result in fees being doubled or$100,00 plus the
normal permit fee,which ever is greater.
OR
U vou are a con[raclor varticiparinr !n 1he Permi[fee Accoun! Svslem and have adequate runds check here
rr vou want [his processed �hrough vour accvunl n �
**Advisory-For appltcable projects, aa Elecbrical Installation Vcrification(El�form, signed by the Elec�ical
Contractoz or Homeowner(for installadons allowed to 6e performed by the homeowner)must be sabmitted
with the permit applicatioa. Applications sabmitted without an EN when snch is reqaized, will not be
pmcessed fot Permit Issuance and w�l be ntarned for completion.
DATE �.1�ZL —aT0/,3
JOB ADDRESS �N. �
OWNER L� � J3�/� �,
CONTRACTOR /I�+� � �a�w
CHECK 6d ALL APPLICABLE
U�SE�ATEGORY
L�Single Family �Duplex OMulti-Family ORental OCommerciai OIndustrial
FUEL B�ias OElectric �Solid SYSTEM ONew B'�lace
❑Oil OSolar �Other
TY�E
�`orced Air ❑Radiant ❑Steam ❑A/C OVent ❑Electric ❑Hot Water �Suppl. OCon. Burner
IS CAIMNEY BEING LINED �io OYes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTLI's being vented.
CHIMNEY TYPE OChimney A ❑Chimney B L9�irect Vent OOther
,� HEAT LOSS l9As Approved ❑Existing ONot Applicable
BTU RATE ❑As Per Plan OVariab(e OOther Value
DESCRiPTION/SCOPE OF ALL WORK BETNG DONE Q BCe Q� � � ,✓act
VALUE(Including lebor and materisls)$_ �� ��(�, ��
ELECTRICAL CONTRACTOR(for projects dot rcqufring an EIV Form)
o�/oi
C-26-2013 08:41A FROM:DRUCKS PLUMBING C92a1722-0651 T0:2365084 P.1
� c�ti oto,n�� � .
� Divufon of4upretion Servica
217 G3urch Arenue
►0 Hox 1170
O,hkah wl s{90.1•lt�o
� OfBee 920.1)6-3050
P�x 920-2]6-SOW .
Electric Installation Verification
I (We)�l"d C K S
(Electncal Contractor Name or Homeowner's Name)
�i s! �10,0%�� /� Nle.�a�r,��. 11J.� S� 9s�
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the foIlowing address:
7�� I,�l! 9� �✓'e Df��e.�� !�/.s �y 9od
(Address where work will be performed)
Thc 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 Condenscr,
Reconnection or new circuit for replacement Electric VlJater Heater or power vented
water heater.
Reconnection of the Service Entrance Cable,Meter Box, alterations 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 the replacement of other perm�neatly wired
appliances/fixturos.
New circuit for the addition of A/C to an lndrvidual dwelling unit, including
required service elech�ical outlets. Not�: Homeowners can only do thefr own
electric on a single family owner occupied h�me. Work o»a condominium,
duplex, rental, or mu/tr-use building would require a Itcertsed ElectricaJ
Controctor.
Other
�
The value ofthis work is $� �( .
I hereby verify this work will be performed in compliance with the License requirements of
Section 11-22 of the Oshkosh Municipal code and further verify.the reconnection/instalIation
will be done in compliance with manufactwer and Electrie code requirements.
-- - � .�� ��Kr�a.J t Z � �3
(Sigoatute of Company OfGcer or Homeowner� (Print Name� (p��
o�ro�