HomeMy WebLinkAbout0130181-HVAC (a/c) VOID CITY OF OSHKOSH No 130181
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 421 FULTON AVE Owner LAURA J STODDART Create Date 05/28/2008
Contractor D & S HEATING AND C OOLING Category 501 -Residential-Air Conditioning 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 Existin Not Applicable Value
BTU Rate As Per Plan Variable Other Value
UselNature
of Work
ALL SPLIT SYSTEM A/C UNIT,
Fees: Valuation $4,260.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
w
^ Permit Voided
$74.50
Date 05/28/2008
Parcel Id # 1004130000
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 cure any n cessa~ryjapprovals before starting such activity.
Signature i~`'/~ ~C~ Date ~-~D~j'
Agent/Owner
Address W1418 TOWN HALL DR PULASKI WI 54162 - 7517 Telephone Number (920) 660-0097
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.
~~'
pN THE WA fR
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1 1 28. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I~vou are a contracto~articipatinQ in the Permit fee Account Svstem and have adequate funds check here
i}'vou want this processed through vour account n
** Advisory - For applicable projects, an Electrical Installation Ver'if'ication (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 sack is required, will not be
processed for Permit Issuance and w>7l be returned for completion.
DATE - 07 ~ G1
JOB ADDRESS ~ a I 7` o I ~ c~/j % ~/~
OWNER_ ~C/l//'~! l/?f'ISei7
CONTRACTOR ~J- S }~, ~;~ 4 ~;~~,~ ~b~~~ ~ ,
CHECK ®ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
FUEL ^Gas ^Electric ^Solid SYSTEM ^New Replace
^Oil ^Solar ^Other
TYPE
^Forced Air ^Radiant ^Steam ^A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CHIMNEY BEING LINED ^No ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B ^Direct Vent ^Other
HEAT LOSS ^As Approved ^Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable ^Other Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE ~~~~d SS/Sr~-r~1 ~~ ~ 1 ~'~`
// ~ ~
VALUE (Including labor and materials)
3.
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) "~-~ Mfr z ~ ~~e(~~/~~-
o~/o~