HomeMy WebLinkAbout0130134-HVAC (furnace & a/c) CITY OF OSHKOSH No 130134
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 1202 SCHOOL AVE Owner RANDAL B MILLER Create Date 05/23/2008
Contractor BLACK-HAAK HEATING Category 502 -Residential-Both Plan
Fuel / Gas Oil Electric Solar Solid
System ^ New ^/ Replace ~ ^ Other __~
/ Forced Air Radiant Steam / A/C Vent ~
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature
of Work
/ INSTALL N
wiring being done by owner) **check
Fees: Valuation $5,500.00 Plan Approval $0.00 Permit Fee Paid $92.50
Issued By: ~~~~ Date 05/23/2008
^ Permit Voided
Parcel Id # 0205230000
In the pertormance 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 (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 of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)236-5050
Fax (920)236-5084
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RECEIVED
MAY 2 3 2008
DEPARTMENT OF
COMMUNITY DEVELOPMENT
HVAC PER1V~~1 P~c~1s1~I SER~Ii~S.RI.v1sION
All information after bold categorli'esLlm(u~stAbe proVvliVded.
Incomplete applications will not be processed.
HK H
ON THE WATER
• 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 aarticiaatinQ in the Permit fee Account Svstem and have adeguare funds. check here
if you want this processed throueh your account (~
DATE ~ ~/~l ` ` a
CHECK B! ALL APPLICABLE
USE CATEGORY
c~Single Faznily DDuplex DMulti-Family
FUEL ,Gas DElectric DSolid
^Oil ^Solar
DRental ^Commercial
SYSTEM DNew
^Other~
DIndustrial
DReplace
TYPE
Forced Air DRadiant ^Steam ^A/C DVent . ^Electric DHot Water DSuppl. DCon. Burner
~i
IS CHIlVVINEY BEING LINED DNo~Yes -LINER SIZE ~ & MANUFACTURER
Note: All chimneys shall be sized per theB~U's being vented.
CHIlVIIVEY TYPE DChimney A DChimney B [~irect Vent ^Other .
HEAT LOSS DAs Approved ~xisting DNot Applicable
BTU RATE ~ Per Plan DVariable DOther Value
DESCRIPTION OF ALL WORK BEING DONE ~~~ v1 ~t C~ ~Fi, r h ~ to ~ A ! L
VALUE (Including labor and all materials including light features) $ ~ ~ l `~' d
ELECTRICAL CONTRACTOR l~'tt D(~'iG~e?n
0 Fvr 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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