HomeMy WebLinkAbout0128266-HVAC
e
OSHKOSH
ON THE WATER
Job Address 535 W 17TH AVE
CITY OF OSHKOSH
No
128266
HVAC PERMIT - APPLICATION AND RECORD
Owner KATHLEEN BENKOSKE
Create Date 10/12/2007
Contractor GRANT SCHULTZ HEATING & COOLING
Fuel ~ Gas UOil
System ~ New
~ Forced Air U Radiant
U Electric I J Hot Water
Chimney Type () Chimney A () Chimney B
Heat Loss . As Approved C) Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
D Replace
U Steam
U Suppl.
C) Direct Vent
U Solar U Solid
D Other
U AlC U Vent
LJ Con. Burner
. Not Applicable
() Not Applicable
() Other
Use/Nature NSFR /INSTALL NEW HVAC SYSTEM FOR NEW HOME "debt acct
of Work
Value
Value
Fees: Valuation $6,600.00
Issued By: ~ ~
Plan Approval
$0.00
Permit Fee Paid
$109.00
Date 12/26/2007
D Permit Voided I
Parcelld # 1404220100
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
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.
Dee 21 07 04:17p
Grant Schultz
920-237-4959
p.2
City ()f Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
<:& ~ --~:" .....I,-;Tf.~
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications wilt not be processed.
. Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box Il28,
Oshkosh WI 54903-1] 28. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
rf VOll are a contractor oar/icipatin,? in the Permit fee Account System and have adequate fUl1ds. check here
i VOll want this I"ocessed throu h vour account
DATE
JJ /dl/07
I
JOB ADDRESS 11 'fry AIJ.L--, _---'-
OWNER-JiOJ.~h~1 J3ij~ _ ~
CONTRACTOR {~r{Jf7 {. Jdz,t.( 11"1. H IlIte-
-
CHECK 0 ALL APPLICABLE
USE CATEGORY
YSingle Family ODuplex DMulti-Family
o Rental
DComrnercial
OIndustrial
FUEL
p(Gas
DOH
DElectric DSolid
o Solar
SYSTEM
ONew
DOther
o Replace
!ePE
pForced Air
o Radiant OSteam DAle OVent o Electric
DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINEDlDNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
PAs Approved
~As Per Plan
DChjmney B
DExisting
OVariable
IW)irect Vent DQther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE
N~.w H(J~
~ G, i}_pO
VALUE (lncluding labor aDd materials) $ t7 Ou......
ELECTRICAL CONTRACTORJI f (.J..r f~ I-Be-kic... .
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor. must be
attached. If not attached or not appl icable, a separate Electrical Permit is required.
10/04