HomeMy WebLinkAbout0125572-HVAC
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OSHKOSH
ON THE WATER
Job Address 525 W 17TH AVE
CITY OF OSHKOSH
No
125572
HV AC PERMIT - APPLICATION AND RECORD
Owner LISA M VOSS
Create Date 04/17/2007
Contractor GRANT SCHULTZ HEATING & COOLING
Fuel ~ Gas UOil
System o New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type o Chimney A () Chimney B
Heat Loss . As Approved () Existing
BTU Rate . As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
I ~
I
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
o Not Applicable
C) Not Applicable
() Other
Use/Nature NSFR (LATE PERMIT) /INSTALL NEW HVAC SYSTEM FOR NEW HOME **debt acct
of Work
Value
Value
Fees: Valuation .rooo
Issued By: WI
Plan Approval
$0.00
Permit Fee Paid
$194.00
Date 06/28/2007
o Permit Voided I
Parcelld # 1404210000
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
AgenUOwner
Address
55 CRIMSON LN
OSHKOSH
WI 54902 -7298 Telephone Number (920) 216-1616
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.
Jun 26 07 07:01 p
Grant Schultz
920-237-4959
p.2
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON _>iF ':.'ATfR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· AppIication(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-] ]28. Commencing work without permit(s) will result in fees being dcmbled or $1 DO.OG plus the
normal permit fee, which ever is greater.
OR
J
e Account S stem and have ade uate unds check here
DATE
(n; J.~- {f7
JOB ADDRESS '5,? ~ tJ _ /7 't!J Aw.
OWNER (is,t{ UtPSJ
CONTRACTOR &'rl{l')( .SellCt flz P V/)C!-,
CHECK 8 ALL APPLICABLE
USE CATEGORY
Wingle Family DDuplex DMuIti-Family
o Rental
DCommerciat
o Industrial
FUEL
}JOas
DOil
DElectric DSolid
DSolar
SYSTEM
ONew
o Other
DReplace
I2:PE
~Forced Air D Radi ant DSteam DAIC o Vent DElectric
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
DHot Wa1er DSuppl. Dean. Burner
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTL" RATE
DChimney A
-glj\s Approved
WAs Per Plan
DChimney B
DExisting
DVariable
;rrJOirect Vent DOther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE
Npw J n J k"llot/i3n 11/l1Jv
VALUE (Including labor and materials) $
ELECTRICAL CONTRACTOR fl, I k r 9/llcj.r/c
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, mustbe
attached. If not attached or not applicable, a separate Electrical Permit is required.
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