HomeMy WebLinkAbout0105086-HVAC (furnace; a/c)OSHKOSH
ON THE WATER
.lob Address 106 W 11TH AVE
Contractor MARTENS HEATING & COOLING
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ADAM J SCHUH
Category 502- Residential-Both
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
105086
10/31/2003
Other
Vent J
Use/Nature DUPLEX/Replace furnace and install central air. *EIV form from Hoehne Electric.
of Work
Fees: Valuation
Issued By:
$6,962.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$110.00
Date 10/31/2003
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 P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number
(920) 685-0111
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
HVAC PERMIT APPLICATIOh0CT 3 1
All information after bold categories must be pro~/i~d.
Incomplete applications will not be I~T~TJ~/~EJ~T 0 F
· Application(s)and fee(s)can be brought to City Hall, Room 205 or mailed t~[pT~c~°~er~c~,~(~ Box1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
no~al pe~it fee, which ever is ~eat~.
J ou are a coOl'actor artici atin in the Permit eeAccountS stem and haveade ate unds check here
~Vou want this processed through voFr account ~
CItECK [] ALL APPLICABLE
U~E CATEGORY
}~ingle Family
FUEL ~as
[SOil
F1Duplex [2Multi-Family F1Rental I"lCommercial Ellndustrial
[]Electric F1Solid SYSTEM F1New []Replace
[] Solar []Other
T E
~orced Air []Radiant []Steam [SA/C FIVent [SEleetric [3Hot Water F1Suppl.[]Con. Burner
Note' All chimneys shall be sized per the BTU seemg yen ea. ·
CmlVINEY TYPE
I-TEAT LOSS
BTU RATE
[sChimney A
[]As Approved
[sAs Per Plan
C1Chimney B
[~Existing
E]Variable
[]Direct Vent F1Other
[]Not Applicable
[]Other Value
DESCRIPTION OF ALL WORK BEING DO~_
VALU~ (Including labo, and .11 m.terials including fight fixtures) $ ~ ~ ~ 0 0 ~f/O, ~
OR ~ctric Installation Ve~ficafion ~rm a~ached(lf Replac~t)
ELECT~CAL CON~CTOR Ele~t~c~ installation of n~//,eplaeement equcment s~ll be done ~ licens~ contractors
3/02
Electric Installation Verification
(We)
(Electrical Contractor Name)
(Address) (City)
(State) (Zip Code)
(Name of party contracted to)
at the following address:
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Q Reconnection or new cimuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water 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.
Reeonnecfion or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ dbO' ~
I hereby verify this work will be performed by an employee of this company and further verify
the reeonneetion / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
(Date)