HomeMy WebLinkAbout0105049-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 102 STERLING AVE
Contractor CUSTOM HEATING & COOLING
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner RUSSELL L KILPELA/P M WIECHERT
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
105049
10/30/2003
Other
Vent J
Use/Nature DUPLEX/Add furnace to heat upper apt (40m btu). *EIV form from Hoehne Electric.
of Work
Fees: Valuation
Issued By:
$2,300.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$39.50
Date 10/30/2003
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 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0 Telephone Number
(920) 235-7263
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
Fax (920) 236-5084
OCT j
HVAC PERMIT APPLICATION
All information after bold categories must
· - ' ~
~co~lete apphcauom will not ~e~.~. ~T 0~
Y DEVELOPMEN
· Apphcatio~(s) ~d fee(s) ca~ be brought to Ci~ HM1, Aoom 205 or ~ilcd to ~specfio~ S~c~O Box 1128,
Oshkosh WI 549034 12g. Coercing wo[~ without pc~it(s) ~il result i~ fccs bcmg doubled or $100.00 plus the
no~al pe~it fee, w~ch ev~ is ~eater.
OR
[f vou are a contractor participating in the Permit fee Account System and have adequate funds~ check here
i fvo~ want this pro c ess ed through vo~r acco~t ~DA~
JOB ADDRESS
OWNER
CONTRACTOR
CI:I3ECK [] ALL APPLICABLE
USE CATEGORY
[3Single Family g3~uplex [3Multi-Family
[2Rental [2Commercial Fllndustrial
FUEL ~ [3Electric FiSolid SYSTEM l"lNew FIReplace
FIOil FISolar FIOther
TYPE
~P6Fced Air FIRadiant FiSteam FIA/C [3Vent FiElectfic [3Hot Water [2Suppl. r-ICon. Burner
IS CItTMNEY BEING LINED [3No [2Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
REAT LOSS
BTU RATE
F1Chimney A
I-lAs Approved
F1As Per Plan
[3Chimney B
FiExisting
[3Variable
& MANUFACTURER
DESCRIPTION OF ALL WORK BEING DONE
[~irect Vent
[2Not Applicable
FIOther Value
[3Other
VALUE (Including labor and all materials including light fixtures) $ c~ ~
ELECTRICAL CONTRACTOR
E For applicable projects, an Electric Installation Verification form, signed by the Electrical Conlzactor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
~/o2
6
(We)
Electric Installation Verification
(Electrical Contractor Name)<
(Address)
(City) (State) , (~ip C~ode)
(Name of patty contracted to)
(Address where work wi~/pefformed)
have been contracted to perform electric installation work for
at the following address:
The nature of the work consists of: (Cheek One or Describe the Nature of Work)
~'~ R~eReconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
__ Reeonneetion or new circuit for replacement Electric Water Heater or power vented
water heater.
__ Reeonneetion ofthe 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,
__ Reconneefion or nc~ circuit for the replacement ofother permanently wired
appliances / fixtures.
__ New circuit for the addition of A/C to an individual dwelling unit (house or the
in~vidual systems in a duplex or condominlum),including required sen, ice
electrical outlets.
Other
The value of this work is $ /fff'~"~ .
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
~-~fi~t~re oPTC:o~ompany O~ffieer)
Name of Officer)
(l~ate)