HomeMy WebLinkAbout0126488-HVAC (a/c)
o
OSHKOSH
ON THE WATER
Job Address 1005 MASON ST
CITY OF OSHKOSH
No
126488
HV AC PERMIT - APPLICATION AND RECORD
Owner NANCY L HOLLAND
Create Date 08/27/2007
Contractor
MAPLE VALLEY HEATING & COOLING L
Category ~~_ResJdential-Air Conditioning
Plan
Fuel
l!J Gas ~
~!'lew
U F~r:ged Air_J
OEJeC~-l
0:: Oil I
U Electric -=:=J
U Solar
_:::::1
U Solid J
~her J
LL~~~~_J
U Radiantl
U Hot Water
~Iace ~
U Steam = I ~ AlC l
~e!:_____J UQ~~~EJ
() Direct Vent -------::. Not Applicable
System
____J
Heat Loss
rLQhimney A () Chimney B
IT~~~-----==O Existing
IT As Per Plan () Variable
Chimney Type
. Not Applicable
--
. Other
-~
~
Value
BTU Rate
Value
29,000
Use/Nature FR /INSTALL MITSUBISHI MINI SPLIT AlC SYSTEM (Electric work being done by Helmer Electric permit #126431)
of Work
Fees: Valuation $5,154.00
Issued By: ~ -----
Plan Approval $0.00
Permit Fee Paid ________~~8.0il
Date 08/27/2007
o Permit VoidedJ
Parcelld # 1307600100
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 ecessary approvals before starting such activity.
Agent/Owner
Date t5'A '7/.::' 7
,/ ,
Signature
Address
N7024 COUNTY ROAD G
ST CLOUD
WI 530791-1525 Telephone Number (920) 999-2720
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.
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THF WATFR
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 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
If you are a contractor particivating in the Permit fee Account System and have adequate funds. check here
if yOU want this processed through your account n
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE t!> -2.... 7-~ 8
JOB ADDRESS ./ tOO 5" /YJr! 56,.J $r-
OWNER A"n.-v.:::.y J-Ic>U-A^h~
CONTRACTOR /!7.-9Pl-E t#z...u::y Ht3A-TuJ4 4 tD~uW4 t.LG
CHECK 0 ALL APPLICABLE
USE CATEGORY
~ingle Family ODuplex OMulti-Family
ORental
o Commercial
o Industrial
FUEL
4sJ.G as
DOH
DElectric DSo1id
DSolar
SYSTEM
$New
o Other
DReplace
TYPE
DForced Air DRadiant DSteam ~A/C DVent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE DChimney A DChimney B DDirect Vent o Other
HEA T LOSS DAs Approved DExisting DNot Applicable
BTURATE DAsPerPlan DVariable DOtherVa1ue ,c'~. bDD ;3rbV
DESCRIPTION / SCOPE OF ALL WORK BEING DONE /;v&"Ff J-L- /IlJ"""?u.-ei~M I
.
muv I 6;:>l-J'r A / t!- ::5'1-</6 Yn
VALUE (Including labor and materials) $ S IS"~, 00
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07/07