HomeMy WebLinkAbout0133109-HVACOSHKOSH
ON THE WATER
Job Address 2741 FOND DU LAC RD
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner NANCY M SAMIDA
No 133109
Create Date 09/25/2008
Contractor BREWER 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 Chimne A Chimney B Direct Vent Not Applicable _ _ _ ]
Heat Loss As Approved Existin Not Applicable ~ Value
BTU Rate As Per Plan Variable Other ~ Value
Use/Nature
of Work
system. 'debit acct
Fees: Valuation $4,500.00 Plan Approval $0.00 Permit Fee Paid $77.50
Issued By: ~~~ %~ Date 09/25/2008
^ Permit Voided ~ Parcel Id # 1414200000
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
AgenUOwner
Address N8804 DOUGLAS ST RIPON WI 54971 -9702 Telephone Number 920-748-6494 866-8(
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.
/25/2008 THU 7:59 FAX 920 748 6520 Brewer Heating ~~~ CITY OF OSHROSH
City of Oshkosh ~
J
Division of Inspection Services ~ ^ ~G~~,
P.o. Box 113o t~'' G ti
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.
I~J001/001
• Application(s) and fee(s) can be brought to City Hall, Roorn 205 or mailed to Inspection Services, PO Box 1 I28,
Oshkosh WI 54903-I 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater. __
OR ~....r.._...~.m..____.._.._..._.._...._..... .....
if you are a contractot~ na~•ticinatin~ in the ermit fee .4ccou t Svstem and have ndeaz~ate funds. c/neck here
** Advisory -For applicable pxojects, an E ctrical Insta Lion Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (fox installation allowe be performed by the homeowner) must be submitted
with the permit application. Applications su ed without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE ~ _Zy" u~
JOB ADDRESS ~'~ ~ ~-~ ~ ~^ L 4 ~
G H c ~ - -- .Sa n., 1^D A
CONTRACTOR_ /~ r 'e.l,y'Cr VG ~ ~
CHECK Q ALL APPLICABLE
USE CATEGORY
'Single Family ^Duplex ^Multi-Family ^Rental ^Cominercial ^Industrial
FUEL ~'ias DElectric ^Solid SYSTEM ^New OReplace
^Oil ^Solar ^Other
TYPE
~Poi•ced Air ^Radiant ^Steam ~A/C ^Vent ^Electric DHot Water ^Suppl. DCon. Burner
IS CHIMNEY BEING LINED DNo ^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 DAs Approved ^Existing DNot Applicable
BTU RATE ^As Per Ptan DVariable ^Other Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE
VALUE (Including labor and materials) $ ~~SUV
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
0/07