HomeMy WebLinkAbout0105359-HVAC (boiler)OSHKOSH
ON THE WATER
.lob Address 995 CUMBERLAND TRL
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner DIANA A THURWATCHER
Category 500- Residential-Heating & Ventilating
L~ Electric
New ] ~] Replace ]
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~) Chimney A ~) Chimney B ~ Direct Vent O 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
~ Solid
105359
11/17/2003
Other ]
Vent
Use/Nature SFR/Replace boiler. *EIV form from Bell Electric.
of Work
Fees: Valuation
Issued By:
$3,283.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$54.50
Date 11/17/2003
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 W8078 HILLCREST COURT HORTONVILLE WI 54944 -0 Telephone Number
(920) 779-8838
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 o f Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903-1 I30
Phone (920) 236-5050
HVAC PERMIT A PLICAT[QN
All information after bold caIegories musl be ~gVde~. 7 2003
Incomplete applications will not be processed.
' ;~q~plication(s) and l~e(s)can be brought to City ltall Room 2()5 ~0~.~m,~ervmcs. t O Box 1128,
Oshkosh WI 54903-1128. (.omme ~cing work without permit(s) will result n lee~g~ or $100.00 pit s
normal permit I~e, which ever is g~eater.
OR
[/Fou are a cOnllZaQ~ff.E[~[(~.~g jLl,~[J~ Permt~e Account SE~te~f!Z~{,zr~qd~tqdLp~t~unds, check here
~(Ut waist this processed through vonr account
CONTRACTOR__d~/_ H~
CHECK [] ALL AI*PLICABLE
USE (ATE. GOllY
~i'~gle Family []Duplex IZlMulti-Family
ElRental []Commercial [] Industrial
FUEL UlElectric DSolid SYSTEM UINew ~fl~.cplace
[]Oil UISolar [3Other ..................
TYPE
U]l:orccd Air [3Radiant ElSteam U1A/C ElVei~t [3Electric ~o1 Water g]Suppl. ElCon. Burner
IS CHIMNEY BEING LINED ~o glYcs - LINER SIZE ........ & MANUFACTURER
Note: All cbimneys shall be sized per thc BTU's being vented.
CHIMNEYTYPE
HEATLOSS
BTURATE
[-IChimney A
[3As Approved
UlAs Per Plan
E1Chimney B
~'Existing
UIVariablc
DESCRIPTION OF ALL WORK BEING DONE
VALUE (h,eh,tUng labnr a,,a all materials inch, ding light tlxtures) $_..._~j ~ ~3 ' O ~
ELECTRICAL CONTRACTOR_~[~._~jk OR [1 Electric Installation Verification form
(We)
Electric Installation Verification
(Electrical Contractor Name)
(Address) (City) (State)
have been contracted to perform electric installation work for /~'-!
at the following address:
(Zip Code)
(Name of party contracted to)
(Address where work will be performed) 303 - 6 ~ ¢~¢
The nat~reZhe work consists of: (Check One ~r Describe the Nature of Work)
_ I/ Reconnection or new cimuit tbr replacement Heating Plant and/or A/C Condenser
Reconnection or new cimuit fbr replacement Eteetric 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.
___ Reconnection or new cimuit for the replacement of other permanently wired
appliances / fixtures.
...... New circuit for the addition ol' A/C to an mdt'vidual dwelling unit (house or the
individual systems ia a duplex or condominium), including required service
electrical outlets.
Olher
The value of this work is $
I hereby verify this work will be performed by an employee of this company and further verify
the reconncction / installation will be done in compliance with manufacturer and Electric code
rcqu remclqls.
(Print Name of Officer)
(Date)
5/02