HomeMy WebLinkAbout0122191-HVAC 0 CITY OF OSHKOSH No 122191
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3200 WHITETAIL LN Owner MIDWEST GENERAL CONTRACTORS Create Date 10/20/2006
Contractor BREWER HEATING Category 512 - Ind. & Comm -Both Plan
Fuel LId Gas U Oil Li Electric 1 Solar I U Solid
System 0 New 1 n Replace 1 ❑ Other
u Forced Air a Radiant Li Steam NC u Vent
L 1 Electric 1 f Hot Water 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 I 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: (kyn Date 10/20/2006
D Permit Voided 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 866-8(
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.
2006 -10 -20 08:57 BREWER 9207486520 » 19202365084 P 2/2
City of Oshkosh
Divi;.ion of Inspection Services
P.O. Box
Oshkosh, W WI I 54903-1130
Phone (920) 236 -5050 _
Fax (920) 236 -5084 OJHKOJH
ON THE WATER I -I
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
lu area co ntractor nar rici p atin g in the Perm( 'e Account em and hay ade'uate and check here
if you want thi_processed through vour account
DATE / 4, -4
JOB ADDRESS 3 f1 /Ai il, ,. ' / 0 OwrrER /l'1��czjy— ��P til 1)
CONTRACTOR g e L ' 1: 0G- 1 t
_ ok _VA
CHECK El ALL APPLICABLE
USE CATEGORY
Mingle Family ODuplex ' Multi Family ❑Rental ❑Commercial ['Industrial
FUEL PGas °Electric °Solid SYSTEM ❑New °Replace
❑Oil ❑Solar ❑Other
E
orced Air °Radiant ❑Steam C ❑Vent ❑Electric ❑Hot Water OSuppl. ❑Con. Burner
IS CHIMNEY BEING LINED ONo °Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented,
CHIMNEY TYPE OChimney A OChimney B 3irect Vent ❑Other 1�
HEAT LOSS DAs Approved ❑Existing ONot Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value O t Q' 1 0
DESCRIPTION OF ALL WORK BEING DONE 174( "0.‘
VALUE $ c9 7 CE,2‘)
ELECTRICAL CONTRACTOR
❑ 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.