HomeMy WebLinkAbout0123965-HVAC (chimney)
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OSHKOSH
ON THE WATER
Job Address 738 W 5TH AVE
CITY OF OSHKOSH
No
123965
HVAC PERMIT - APPLICATION AND RECORD
Owner DANIEL B/LlSA S AVERKAMP
reate Date 03/28/2007
I
I
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
U Solar
IJ Solid
Contractor MARX MECHANICAL
Fuel U Gas UOil
System o New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type () Chimney A () Chimney B
Heat Loss :C) As Approved () Existing
BTU Rate () As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating
U AlC
U Con. Burner
. Not Applicable
U Vent
. Not Applicable
. Other
Value
Value
Use/Nature SFR / Replace existing chimney liner with 3" liner.
of Work
Fees: Valuation
Plan Approval
$0.00
Permit Fee Paid
$25.00
Issued By: Date 03/28/2007
o Permit Voided I arcelld # 0602490000
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 ork
described in this permit application within an easement, the City strongly urges the permit applicant to contact the ease ent
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Oat
Agent/Owner
Address
4535 STATE ROAD 91
OSHKOSH
WI 54904 - 6304 Telephone Number 920-235-6510
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Per it Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), yo r Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is re eived. Work may
continue if the inspection is not performed within two business days from the time the project is read .
Ci1y of Oshkosh
Division oflnspectiolJ Services
P.O. Box l130
Oshkosh, WI 54903- 1 l30
Phone (920) 236-5050
Fax (920) 236-5084
~
H~D H
HVAC PERMIT APPLICATION
All infon11atioll after bold categories mus1 be provided.
incomplete applications will not be processed.
. Application(s) and fe'e(s) can be brought to City Hall, Room 205 or mailed to Inspection Servi es, PO Box 1128,
Oshkosh WI 54903- I 128. Commencing work Witl10Ut pennit(s) will result ll1 fees being dOD ed or $100.00 plus the
normal pennit fee, which ever is greater.
OR
Jfvou are a contractor lJorficipotinQ' in the Permit fee Account Svstem'ond have adequ te unds check here
if !'au wont this processed through Four account n
I
DATE 0-J
-o~
JOB ADDRESS 13 ~ W Si-h ~t:
OWNER [)AN . ~VeUfm\f T
I
CONTRACTOR MARX MECHANICAL INt
I
CHECK 0' ALL APPLICABLE
USE CATEGORY
~Sil1g1e Fall'llly DDuplex DMulti-FamiY o Relltal
FUEL DGas DE1ectric DSolid I SYSTEM DNew
o Oil D Solar · ~Other
~~~ced Air o Radi""t OSteOID DAlC oleut OEleetde DHet Wale; OSuppl. DCen. Bume,
IS CHIMNEY BEING LINED DNa ~y es - L*R SIZE 3 LI
Note: All chinmeys shall be sized per the BTU's being vrted.
CHIMN~Y TYPE DChinmey A DChinlney B DDirect Vent
BEA T LOSS DAs Appmved DExisting DNot Applicable
BTU RATE DAs Per Plan Dvar~.lbJe DOtl1er Value
DESCRIPTION OF ALL 'VOHK BEING DON ' ~e-PLfr(.f ~l <;. TlN'
LlN
DCommerciaJ
Industrial
& MANUFACTURER FLf1(. L
OOther
j VY\Nl?1
V A}-UE (Including labor and mat~rj3Js) $
W
I
ELECTRICAL CONTRACTOR rJ f\
o For applicable pmjects, an Electric Instal ation Verification form, sigl1ed by the Electri al Contractor, must be
attached. If not attached or not applicable, separate Electrical Permit is required.
10/04