HomeMy WebLinkAbout0122192-HVAC l CITY OF OSHKOSH No 122192
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3190 WHITETAIL LN Owner MIDWEST GENERAL CONTRACTORS Create Date 10/20/2006
Contractor BREWER HEATING Category 512 - Ind. & Comm -Both Plan
Fuel ❑✓ Gas U Oil 1 J Electric U Solar U Solid
System 0 New 1 n Replace ! ❑ Other
.✓f Forced Air ❑ Radiant U Steam Lij NC U Vent
U Electric U Hot Water I U Suppl. U Con. Bumer
Chimney Type J Chimney A () Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing 0 Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable 0 Other Value
Use /Nature New multifamily 6 -unit. State Approval #1314647. * *DEBIT ACCT * *.
of Work
Fees: Valuation $27,000.00 Plan Approval $0.00 Permit Fee Paid $320.00
Issued By: al-if, Date 10/20/2006
❑ Permit Voided I Parcel Id #
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 N8804 N DOUGLAS ST RIPON WI 54971 -0 Telephone Number 920 - 748 -6494 866-8C
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.
06 -10 -20 08 :57 BREWER 9207486520 » 19202365084 P 1/2
City of Oshkosh
Division of Inspection Services
P.O. Box ;130
Oshkosh, WI 54903 -1130
4
Phone (920) 236 -5050
Fax (920) 236-5084
0/1
ON THE WATER
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 , artici,atin, in the Perini -e Account em and hav• ade'uate ands check here
if you want this processed through your account
•
p I
DATE / t.) - u" 0 b
JOB ADDRESS 3 I - 1 U I - I— w� n, .-t�,, 1
OWNER i k .-Lfre — -9e ' te , . it • 44-c.rt - < %-
CONTRACTOR 1 ‘,, t'.o,, - -� - t \
) '?C CHECK 0 ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex }Multi- Family ❑Rental ❑Commercial ❑Industrial
FUEL peas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar °Other
TYPE
)@Forced Air ❑Radiant ❑Steam r318/C ❑Vent DElectric OHot Water ❑Suppl. ❑Con. Burner
IS CHIlVMNEy BEING LINED ❑No ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A DChitnney B 'birect Vent °Other q
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable `b
BTU RATE DAs Per Plan ❑Variable °Other Value o '
DESCRIPTION OF' ALL WORK BEING DONE }1
�a
1/ � �
-
VALUE $ 9 7 ____
ELECTRICAL CONTRACTOR
0 For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.