HomeMy WebLinkAbout0133837-HVAC CITY OF OSHKOSH No 133837
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3201 W 9TH AVE Owner RUSCH HOMES LLC Create Date 11/05/2008
Contractor GRANT SCHULTZ HEATING & COOLING Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas ^ Oil Electric _ _ ~ Solar Solid
System ^/ New ^ Replace J ^ Other
/ Forced Air Radiant Steam ~ A/C Vent
Electric Q-Hot Water Suppl. _ ~ Con. Bumer
Chimney Type Chimney A Chimney B Direct Vent Not Applipble
Heat Loss ___
As Approved __
Existing
Not Applicable Value
BTU Rate
As Per Plan
Variable ---
Other Value
Use/Nature
of Work
acct
Fees: Valuation
Issued By:
Plan Approval $0.00
^ Permit Voided
Permit Fee Paid $77.50
Date 11/05/2008
Parcelld # 1342952800
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 Ciry strongly urges the permit applicant to contact the easement
holders} and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 55 CRIMSON LN OSHKOSH WI 54902 -7298 Telephone Number (920) 216-1616
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
OfHKOfH
ON THE WATFR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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. / f~
DATE l~ ~ 3 < O "
JOB ADDRESS J~~'
OWNER aG 3'~ /'1
CONTRACTOR Cam' -r~zl~ ~ -S~ L~ ` ~~ n ~ C~
CHECK Q ALL APPLICABLE
U E CATEGORY
Ingle Family ^Duplex ^Multi-Family
FUEL ~as ^Electric ^Solid
^Oil ^Solar
~PE
Forced Air ^Radiant ^Steam ^A/C ^Vent
IS CHIMNEY BEING LINED ^No ^Yes -LINER S
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE Chimney A
HEAT LOSS s Approved
BTU RATE As Per Plan
^Rental ^Commercial ^Industrial
SYSTEM ~iew ^Replace
^Other
^Electric ^Hot Water ^Suppl. ^Con. Burner
IZE & MANUFACTURER
^Chimney B . ect Vent ^Other
^Existing ^Not Applicable
^Variable ^Other Value
DESCRIP~ON /SCOPE OF ALL WORK BEING DONE f Y~ 1.~7 47 ~t~ L ~/O ~. ~`'''~ ~/~ ~i
~,/~ Di „ /
VALUE (Including labor and materials) $ ys``f~.
ELECTRICAL CONTRACTOR (for projects not re uirin an EIV Form) ~~~ ~S
9 g
o~lo~