HomeMy WebLinkAbout0130152-HVAC (furnace & a/c) CITY OF OSHKOSH No 130152
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1112 W BENT AVE Owner JUDY M SCHREIBER Create Date 05/27/2008
Contractor MARK WEBER HEATING & COOLING IN 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 Chimne A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value
UselNature SFR /REPLACE FURNACE AND A/C, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES, LLC **debt acct
of Work
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid
Issued By: _~~~,,_
^ Permit Voided
$55.00
Date 05/27/2008
Parcel Id # 1206900000
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
AgentlOwner
Address 1075 ISLAND ESTATE CT OSHKOSH WI 54901 - 1341 Telephone Number 235-1523
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
01HI_ 01H
ON THE WATFR
~ 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
** 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
JOB ADDRESS/ ~ ~~,/ ' ~ ~ ~ -
OWNER t C-,~-~ .~~' ~'7~ (~~~Y~
CONTRACTOR~G~i?~ ~~.~ t~Ze
CHECK 0 ALL APPLICABLE
USE CATEGORY
~ingle Family ^Duplex ^Multi-Family
FUEL was ^Electric ^Solid
^Oil ^Solar
TYPE
Forced Air ^Radiant ^Steam ~AlC OVent
IS CHIMNEY BEING LINED ^No ^Yes -LINER S
Note: Al! chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B
HEAT LOSS DAs Approved ^Existing
BTU RATE ^As Per Plan ^Variable
^Rental ^Commercial ^Industrial
SYSTEM ^New ~Zeplace
^Other
^Electric ^Hot Water ^Suppl. ^Con. Burner
IZE & MANUFACTURER
,.Direct Vent
^Not Applicable
^Other Value
ON /SCOPE OF ALL WORK BEING DONE R-~-~ 1!IF'~~t1 ~ d ~ ~ S~~
VALUE (Including labor and materials) $ ~ ~W~C
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
^Other
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