HomeMy WebLinkAbout0124163-HVAC (furnace & A/C)
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OSHKOSH
ON THE WATER
Job Address 1544 SANDERS ST
CITY OF OSHKOSH
No 124163
HVAC PERMIT -APPLICATION AND RECORD
Owner LEROY EIARLEEN A GRANCORBITZ R TR
Create Date 03/20/2007
Fuel
~ Gas
D New
~ Forced Air
U Electric
Chimney Type [) Chimney A
J
Don
Category 502 - Residential-Both
U Electric USolar ~
~ Replace
U Steam
U Suppl.
Plan
Contractor
COMFORT SOLUTIONS LLCIONE HOUR
U Radiant
I I Hot Water
QChimney B
. Existing
. Variable
~ Ale
U Solid
CLQther
U Vent
System
~
. Direct Vent
U Con. B~
() Not Applicable
BTU Rate
K:) As Approved
K:) As Per Plan
o Not Applicable
() Other
Value
Heat Loss
Value
~
Use/Nature FR 1 Replace furnace & Ale. Electrical contractor is Van Ert Electric.
of Work
Fees: Valuation $4,271.00
Issued By: ~'\J
Plan Approval
$0.00
Permit Fee Paid
$74.50
Date 04/11/2007
D Permit Voided I
Parcelld # 1306930100
I"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 nota 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
OSHKOSH
WI 54904 - 9794 Telephone Number 920-982-3323
--
Address 5165 GREEN VALLEY RD
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.
d.~5LI
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City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, VVI54903-ll30
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
. ON THE WATER
HVAC 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 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
Ifvou are a contractor particivatinf! in the Permit fee Account Svstem and have adeCluate funds. check here
if vou want this processed through vour account n
DATE
z -Z(P -Or-
JOB ADDRESS /S~'1 Sa.nk-.5 5-frJ
OWNER LfC..((~ GrCVl'~ \o.,~ ~
CONTRACTOR Cn'N'k-\- Sa~Oor\S
CHECK 0' ALL APPLICABLE
USE CATEGORY.
~ingle Family o Duplex DMulti-Family
o Rental
o Commercial
o Industrial
FUEL
~Gas
OOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
J(Replace
TYPE
~Forced Air o Radiant DSteam ~C o Vent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED )(No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
DChimney B
EExisting
~V ariable
~Direct Vent o Other
ON ot Applicable
OOther Value
DESCRIPTION OF ALL WORK BEING DONE
~\o..c.... +v...~~ d.IV'\~ AI Co ~ I
Ale. (~isA"i"', ~~s~s rrLfl~L~!.
70 K. +v...r-v'\o...uz... o..H'Ic! OJ ~
c:o
VALUE (Including labor and materials) $ 4- ~ r \ . -
ELECTRICAL CONTRACTOR "0Jr\ &-+ L~\ '--
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.
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10/04