HomeMy WebLinkAbout0123307-HVAC (furnace & a/c)
G
OSHKOSH
ON THE WATER
Job Address 1843 ARIZONA ST
CITY OF OSHKOSH
No
123307
HVAC PERMIT -APPLICATION AND RECORD
Owner JASON ELLIS
Create Date 01/25/2007
Contractor OWNER
Fuel ~ Gas UOil
System o New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type ~) Chimney A . Chimney B
Heat Loss U As Approved . Existing
BTU Rate ,. As Per Plan () Variable
Category 502 - Residential-Both
U Electric
o Replace
U Steam
U Suppl.
o Direct Vent
Plan
U Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
() Not Applicable
() Not Applicable
C) Other
Value
Value
Use/Nature SFRI Replace furnace and install AlC.
of Work
Fees: Valuation
$4,000.00
~
Plan Approval
$0.00
Permit Fee Paid
$70.00
Date 01/25/2007
Issued By:
o Permit Voided I
Parcelld # 1405260000
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 necess approvals before starting such activity.
Signature
Date
I v J-f v f> 7
Agent/Owner
Address
OSHKOSH
WI 54901 - 0
Telephone Number l.3 I "t( h"'il1
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 Osi'ikosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
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 $100.00 plus the
normal permit fee, which ever is greater.
OR '
If y'OU are a contractor participatin!! in the Permit fee Account System and have adequate funds. check here
if yOU want thislJrocessed throuf?h vour account n '
DATE I ~ J.., S-" 01
JOB ADDRESS I? l13 /J-r\L.o"v(J)
, OWNER ~ 0-."'15 A) ~ ( l s'
. CONTRACTOR LusToM. 1--1 ('~"'j ~ Coo {,I A(J
CHECK Iii ALL APPLICABLE
USE CATEGORY
~ingle Family DDuplex o Multi-Family
DRentaI
DCommerciaI
DIndustrial .
FUEL
~as
DOi!
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
.J!Replace
TYPE \..-
)?1Forced Air DRadiant DSteam ..AsJA/C DVent DElectric
IS CHIMNEY BEING LINED )tNo'OYes - LINER SIZE
Note: All chiinneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A)1Chimney B
HEAT LOSS ~~ Approved ~xisting?
BTU RATE T ~ Per Plan OVariable .
DRot Water DSuppl. DCon. Burner
& MANUFACTURER
DDirect Vent
EJNot Applicable
DOther Value
DOther
DESCRIPTION OF ALL WORK BEING DONE
((fJ~pln r::( ~\ ~v
~I;'/Q/\ A c:
VALUE
.$
4 ()oo
,
~01 vl
\\~6 1~1J~
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