HomeMy WebLinkAbout0106050-HVAC106050
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
DEL TRITT CONSTRUCTION
Job AddressOwner
1058 BISMARCK AVE
Create Date11/25/2003
ContractorTHOMPSON HEATING AND COOLING SERVICECategory502 - Residential-BothPlan
OilElectric
üü GasSolarSolid
Fuel
üü NewReplaceOther
System
üü Forced AirRadiantSteam üü A/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue
Use/Nature
NSFR/ Install furnace, A/C ductwork, gas pipe.
of Work
Plan Approval$0.00
Fees: Valuation$4,360.00Permit Fee Paid$71.00
Issued By:Date01/13/2004
Permit Voided
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.
SignatureDate
Agent/Owner
Address901 OTTEROshkoshTelephone Number920-426-3095
WI54901-0
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.
G-1
, &
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
All infonnation 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 vou are a contractor varticipatinf! in the Permit fee Account Svstem and have adequate funds. check here
if vou want this processed through vour account n
DATE
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JOBADDRESS/~ gS'#/he~
,
OWNER 72=z' '/0,L~
CONTRACTOR ~~~/'J /k~9 i~-<<7' ~p/ee-~
CHECK Ii1 ALL APPLICABLE
~E CATEGORY
]lStSingle Family o Duplex
DMulti-Family
DRental
o Commercial
o Industrial
FUEL
!i.Gas
DOil
DElectric DSolid
DSolar
SYSTEM
laNew
DOther
DReplace
TYPE
li(Forced Air DRadiant DSteam J2(A/C DVent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CmMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
DChimney B
DExisting
DVariable
DDirect Vent DOther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE ~;;;;r#d fi/Zft/~, //<"!:- A/cTa/,,~
G~ '-p/;:x3=
/' /
VALUE (Including labor and all materials including light fixtures) $ /'3~ c
ELECTRICAL CONTRACTOR
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02