HomeMy WebLinkAbout0134069-HVAC (furnace)CITY OF OSHKOSH No 134069
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 100 W FERNAU AVE Owner LAKESIDE PACKAGING PLUS INC _ _ Create Date 11/18/2008
__ ____
Contractor RJ KAMPO PLUMBING & HEATING INC Category 510 -Ind. & Comm-Heati_nc,~& Ventilating Plan _ _ __
Fuel / Gas Oil Electric ~ Solar ~ Solid _
System ^ New ~ ^/ Replace ~ Other j
/ 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 135,000
Use/Nature Replace furnace. EIV signed by Triumph Electric.
of Work
Fees: Valuation $4,000.00 Plan Approval _ $0.00 Permit Fee Paid _ $70.00
Issued By: /~~/y}t/J Date 11/18/2008
^ Permit Voided Parcel Id # 1519601800
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 1000 S WESTLAND DR APPLETON WI .54914 - 8862 Telephone Number (920) 730-9600
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 (~~.lll( 1
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
If you are a contractor narticiDatinQ in the Permit fee Account System and have adequate funds check here
if you want th-s processed through your account n
** 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) mast 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 retained for completion.
DATE ~~~~~~~a
JOB ADDRESS ~/)h ~A-V1 ~~
OWNER ~
CONTRACTOR ~ G~
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 DAs Approved Existing ^Not Applicable
BTU RATE OAs Per Plan ^Variable ^Other Value 13~, r7b6
DESCRIPTION /SCOPE OF ALL WORK BEING DONE
VALUE (Including labor and materials) $ ~~~ ,
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
o~~o~
11/17/2008 16:03 9207300969
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KAMPO PLG
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