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HomeMy WebLinkAbout2007-HVAC (system) e CITY OF OSHKOSH No 123962 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3245 S WASHBURN ST Owner BERGSTROM FOX VALLEY INC reate Date 03/28/2007 Contractor HURCKMAN MECHANICAL IND., INC. Category 512 - Ind. & Comm-Both Pan X3-1895-0107-H Fuel ~ Gas I UOil I ~ Electric I U Solar I U Solid I System o New I D Replace I 0 Other I l!J Forced Air I U Radiant I U Steam I l!J AlC I l!J Vent I U Electric I .. U Hot Water I I I Suppl. I U Con. Burner I Chimney Type D Chimney A () Chimney B . Direct Vent () Not Applicable I Heat Loss . As Approved C) Existing () Not Applicable I Value BTU Rate . As Per Plan () Variable C) Other I Value Use/Nature HVAC system as per State Trans ID # 1367093 to include RTU's, make-up air, ventilation, radiant heat, ductwo k, and vehicle exhaust. of Work Fees: Valuation $180,000.00 Plan Approval $0.00 Permit Fee Paid $1,085.00 Issued By: Date 03/28/2007 D Permit Voided I I arcelld # 1365010000 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 easem ~nt holder(s) and to secure any necessary approvals before starting such activity. Signature Oat Agent/Owner Address P.O. BOX 10977 GREEN BAY WI 54307 - 977 Telephone Number 920-499-8771 -- To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Perm t 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 rec eived. Work may continue if the inspection is not performed within two business days from the time the project is read, . City of Oshkosh {~. Division oflnspection Services P.O. Box 1130 Oshkosh, WI 54903-1] 30 Phone (920)236-5050 Fax (920) 236-5084 MAR 2 6 2007 '- HV AC 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 Servi es, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being daub ed or $100.00 plus the normal permit fee, which ever is greater. OR LLY-Oll are a contractor arlici at in in the Permit ee Account S stem and have ade ua e unds. check here if' VOIl want this processed throuzh your account n DATE 3., 2. "0-=1 JOB ADDRESS 3Vc...'S S ,Wf\Si4'i3>O'E!'i 5..... OWN E R '~?e7s;i\"\C ,,,,,- c..,,'l.'1'a ~;f\"ll c::. N CONTRACTOR \.\..u''YL~~~ MUctA~..;l'..cALX""C CHECK ~ ALL APPLICABLE r USE CATEGORY OSingle Family ODuplex DMulti-Family DRental )dCommercial Industrial FUEL ){bas DOil ~Iectric DSolid DSolar SYSTEM DNew DOther TYPE ~orced Air ~Radiant DSteam ~A/C DVent DElectric DHot Water DSuppl. DCon. Burner IS CHIMNEY BEING LINED DNa DYes - LINER SIZE ~ote: All chimneys shall be sized per the BTU's being vented. & MANUFACTURER CHIMNEY TYPE HEAT LOSS BTU RATE DChimney A ~s Approved [Q1\s Per Plan I!1thimney B DExisting DVariable DDirect Vent DOther DNot Applicable DOther Value DESCRIPTION OF ALL WORK BEING DONE ? UN, ~o"'(.:.. V A LUE (Including labor and materials) $ \ eo ,Oc:t.).. <:,e;! r'-" I ELECTRICAL CONTRACTOR '" .. ~\'V"--'-( --- .... ~\..c.... CJ For applicable projects, an Electric Installation Verification form, signed by the Electric I Contractor, must be attached. If not attached or not applicable, a separate Electrical Permit is required. 10/04