HomeMy WebLinkAbout0105087-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 315 FULTON 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 CARLTON L PAULUS
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO 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
L~ Solid
105087
10/31/2003
Other J
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Hoehne Electric.
of Work
Fees: Valuation
Issued By:
$4,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$65.00
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 oskkosh
Division of Inspection Services
RECEIV
O~l~:osh, Wi[ 54903-] 130
Fax (920) 236~5084 OCT 3 I ~U[~-d oX ~
HVAC PE MIT PLICATION
I~omplete appl~caions win aot be ~[~ DEVELOPMENT
Application(s) and f~e(s) can be brought to CiW Hall, ~om 205 or n~ted to Iaapecfi~ S~ces, PO Box 11
OshkeshWI 54903-112g. C~neingwovkwifl~oatpenuit(s)willres~tinfeesbeingdoubledor$100.00plm~e
~o~M p~Jt fee, which ever is
CI:I~CI~ ~ ALL Ap~LICA,I~LE
USE cATEGO
)~Single Family ~Duplex ~Multi-Fmily ~Rental ~.Com~cial
F~L ~.}as ~El:ectric ~Solid SYSTEM ~N~ ~R~l~e
~0{1
· ~3tl~E C
xj~lF..o, rced Ai~ ~Ra,rliaat D Steam ~A/ [lVent ElEleetric. E1Hot Water EISappt. EICon, Burner
IS C~Y B~G LINED ~o ~Yes - L~R S~E _~ & M~A~R.
Note: Ali chimneys s~ Be sized per ~e B~'s be~ag vented,
C~{EY T~E ~Chhmey A ~Chimney B DDireet Vent ~O~er
~AT LO:SS ~As Approved ~Existi~g ~Not Applicable
B~J RATE ~As Per Plan ~Variable ~Oth~ Value _
WO~ BE~G BO~
DESCR~TION 0~' ALL ~ ~' ,
ELECTIklCAL cONTP~CTOR__~
Ela. etvfe~ktnsi~ltatlon of ne~/reptaeemem equipment shall be done by licensed eontrae
Electric Installation Verification
(E]ect~eal Contractor
(Address) (City)
have been contracted to perform electric installation work for
at the following address:
(State) (Zip Code)
(Name of party contracted to)
(Address where work will be performed)
The nature of the work consists off (Check One or Describe the Nature of Work)
X Rec°nnecfion or new circuit 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.
Recormecfion 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 omlets.
Other
The value of this work is $
I hereby verify this work will be performed by an employee of this company and further verify
the recermecfion / installation will be done in compliance with manufacturer and Electric cede
requirements.
~'f~a ure o~ Company Officer)
(Print Name of Officer)
(Date)