HomeMy WebLinkAbout0105278-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 1513 ELMWOOD AVE
Contractor WESLEY HEATING & COOLING INC
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 CAROL S VAUGHAN
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
105278
11/12/2003
Other
Vent J
70m btu
Use/Nature SFR/Replace furnace. *EIV form from Solar Electric.
of Work
Fees: Valuation
Issued By:
$3,600.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$59.00
Date 11/12/2003
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 1736 SAL STREET GREEN BAY WI 54302 -0 Telephone Number
(920) 468-6951/235-6
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 (92~}) 236-5084
O/HKO/H
HVAC PERMIT APPLICATION
All information after bold categories 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 WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if Fou want this processed through Four account
JOB ADDRESS / 5-/5 ~£/'/q ~4/~9~ D
OWrqeR 7~ ~ o ~ a ~ ~ F
COre,tV, AC-a-OR ~;t~-W ~',+F-/A)6 4
DATE
CHECK E ALL APPLICABLE
I~SE CATEGORY
fi~kSingle Family F1Duplex F1Multi-Family E]Rental ElCommercial Ellndustrial
ced Air [3Radiant F1Steam F1A/C F1Vent FlElectric
IS CHIMNEY BEING LINED [3No ~Yes - LINER SIZE
Note: All chimneys shall be sized per ~e BTU's being vented.
F1Hot Water [3Suppl. [3Con. Burner
& MANUFACTURER ,~L,~'}(//-,/A)~",'~-~
CHIMNEY TYPE []Chimney A FIChimney B ~irect Vent
HEAT LOSS CAs Approved J~Existing [3Not Applicable
BTU RATE [3As Per Plan EVadable [3Other Value
D SC_mPT _woux u mC
VALUE (Including labor and all materials including light fixtures) $ --~ ~ d3~) . (~ ~
~j~For applicable projects, an ElecWic Installation Verification form, signed by the Electrical Con,actor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
11/11/03 14:05 FAX 920 236 7725 Solar Electrlc ~01
Hov I1 03 0;~:37p tdHC OGH 235-?550
Electric Installation Verification
(State)
The nature of the work conSis¢~ of: (Check One or Descn'bc ~he Ne~m of W~)
R~on or n~ ~t f~ ~ ~c W~ H~ or ~ ~
wa~ h~.
~I~ / ~.
New c~t for ~e ~on of ~ ~ ~ i~i~d~ ~el~ ~ ~ ~ ~
el~ ouOe~.
0~
Thc~alueofth~sworkis$ /,.~0. O0 .
I hereby v m-if'y Ibis work will be pe~orm~d by an employer o f this ~pany and fmil~r vcrlfy
thc re~onne~lion / inst.11~tiOn Wffi ~ done iff COIl~lln~ With msnu~actu~ and Ela:~ic Gode
-
(l~int~sme of Officer)