HomeMy WebLinkAbout0133362-HVAC (boiler)I~ CITY OF OSHKOSH No 133362
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 816 GREENFIELD TRL Owner MICHAEUJANE GORDON Create Date 10/08/2008
Contractor MARK WEBER HEATING 8 COOLING IN Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oii Electric
-]
~lar-------
[~ Solid--
System ^ New ~ ^/ Replace ~ Other
Forced Air Radiant Steam ^-A/C ~ ^ Venn
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 FR /REPLACE BOILER, EIV SIGNED BY ELECTRICAL CONSTRUCTION SERVICES LLC (Greg Davis) "*debt acct
of Work
I
Fees: Valuation $1,900.00 Plan Approval
Issued By: ~1~ ~ ~-
$0.00
Permit Fee Paid $38.50
Date 10/08/2008
^ Permit Voided
Parcel Id # 0613992600
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 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 oflnspection Services
P.O. Box 1134
Oshkosh, W 54943-1134
Phone (920) 236-5054
Fax (924}236-5484
HVAC PERMiT APP~lCATiON
All information after bold categories must be provided.
Incomplete applications will not be processed.
o.~oKO.~o
L'N 7s'F 4JAT~R
Application(s) and fee(s) can be brought to City Hall, Room 2Q5 or mailed to Inspection Services, PO Box 1128,
Oshkosh Wl 54903-1128. Commencing work without permit(s) will result in fees being doubled or ~100A0 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 horneowner) 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 lC~ ' _~~
JOB ADDRESS ~~~ ~-, G'Z~ F-' ~~Z- ~ _
CONTRACTOR~L~~~(Z ~; 1~~X,~~ ~~-Z
CHECK Q ALL APPLICABLE
USE CATEGORY
,l~ingie Family ^Duplex LlMulti-Family (Rental
FUEL 1',~`6as ClElectric ^Solid ~ SYSTEiYi
^Oil t~Solar
TYPE
^Forced Air ~Badiant ClSteam ^A/C 1~Vent ^Eiectric
IS CH1iVINEY BEING LItiEI) ONo ^`a''es - LL'~ER SIZE
Note: A(1 chimneys shall be sited per the BTU's being vented.
^Commercial ^Industrial
^New j~eplace
ClOther _
Hot Water L~Suppl. ^Con. Burner
~, IAr~L;FACTURER
CHIitiiNEY TYPE ~himney :~ ~himney B ^Direct Vent ^Other
HEAT LOSS s Approved ~Lxistmg 1~Not Applicable
BTU RATE ^As Per Plan C3Variable QOther Value _v _
DESC IPTION /SCOPE OF ALL WORK BEI~'G DONE '~(.,.i~'7~~/T- -L'2~"-~,~~!~~~st!
VALUE (Including Tabor and materials) ~ ~ ~ ~" _~
ELECTRICAL COiYTRACTOR (far projects not requiring. un EIV Form)
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