HomeMy WebLinkAbout0125525-HVAC
G
OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
125525
HV AC PERMIT - APPLICATION AND RECORD
Job Address 3880 EDGEWOOD RD
Contractor BLACK-HAAK HEATING
Fuel ~ Gas UOil
System I:?l New
~ Forced Air U Radiant ~
U Electric U Hot Water I
Chimney Type KJ Chimney A ~ Chimney B
Heat Loss . As Approved () Existing
BTU Rate . As Per Plan () Variable
Owner RICHARD J/NANCY S CASEY
Create Date 05/29/2007
Category 502 - Residential-Both
I Electric
D Replace
U Steam
U Suppl.
. Direct Vent
Plan
J Solar U Solid _
D Other
~ AlC U Vent
U Con. Burner
() Not Applicable
C) Not Applicable
() Other
Use/Nature NSFR 1 INSTALL FURNACE AND AlC IN NEW HOME "check #15665
of Work
Value
Value
l
I
____J
FeeS' Valualio" ~ $7,200.00
Issued By: ~ -,-- ----
Plan Approval
$0.00
Permit Fee Paid
$118.00
Date 06/27/2007
D Permit VO.!ged I
Parcelld # 1280150203
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.
Signature
Date
Agent/Owner
Address
PO BOX 7075
APPLETON
WI 54912 - 7075 Telephone Number 920-757-9990
---
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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 Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RE~~~~ED~ .
DEPARTMENT OF -0
COMMUNITY DEVELOPMEN ifHKOfH
INSPECTION SERVICES DIVISIul'J 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
J ou are a contractor artici atin in the Permit ee Account S stem and have ade check here
ou want this rocessed throu It our account
DATE~
JOB ADDRESS .~~{) fjj~R.AJJDOd Road ) \0Stl..\GDs\1.
OWNER \ Qd\S~/~ .
CONTRACTORj3 \a fx:.-~ Ctl1\\ *tf JJJh ~ ~.
CHECK ~ ALL APPLICABLE
USE CATEGORY
~Single Family .'ODuplex OMulti-Family
ORental
OCommercial
OIndustrial
FUEL
~Gas
DOil
DElectric OSolid
OSolar
SYSTEM
MNew
DOther
DReplace
TYPE
~Forced Air DRadiant OSteam 1(A/C DVent DElectric
IS CHIMNEY BEING LINED DNa DYes . LINER SIZE N \-A
Note: All chimneys shall be sized per the BTU's being vented.
DHot Water DSuppl. DCon. Burner
& MANUFACTURER~ A
CHIMNEY TYPE OChimney A DChirnney B Jl{Direct Vent o Other
HEAT LOSS XtAs Approved DExisting DNot Applicable
BTU RATE )81As Per Plan DVariable OOtherValue
DESCRIPTION OF ALL WORK BEING DONE...Jli~tzul -f1AJtlace./ CU1 ct ~ C I 0
().. V\{,,\A} \'\ Dmt · .
VALUE (Including labor and all materials inCluding light fixtures) U (1) DO, 00
ELECTRICAL CONTRACTOR SUb- D~ntrOL-kd '-W\ VU 'oui\d eY.
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.
Vexrril~ -Re ft ,\~ \ OD
9/02