HomeMy WebLinkAbout0143758-HVAC 0 CITY OF OSHKOSH No 143758
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1020 -1142 S KOELLER ST Owner KOELLER ONE LLC Create Date 10/21/2010
Contractor VETERANS MECHANICAL SERVICE Category 510 - Ind. & Comm - Heating & Ventilating Plan
Fuel [✓] Gas 1 p Oil p Electric ❑ Solar j ❑ Solid
System p New Q Replace p Other
p✓ Forced Air p Radiant USteam 1 A/C H Vent
Electric p Hot Water p_Suppl. H Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent ! Not Applicable 1
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use /Nature COMM\ Hobby Lobby Replace 5 RTUs
of Work ( /// f s /el) eHe -)
Fees: Valuation $11,600.00 Plan Approval $0.00 Permit Fee Paid $176.00
Issued By: ke Date 10/21/2010
❑ Permit Voided Parcel Id # 1308490000
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 re anssa provals b fore starting such activity.
Signature � 0&114 / Date A -.2 r l
Agent/Owner
Address 33 REEF CT APPLETON WI 54915 -0 Telephone Number 920 -284
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 OfHKOf H
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 participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account fl
** 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.
/ D /�' DATE // 2 /- /0
JOB ADDRESS / �/0 S v 7 // r S T
OWNER ie4b / 5-/
CONTRACTOR VQt Ar $ SPC'v/(
P
CHECK FB ALL APPLICABLE
USE CATEGORY
❑ Single Family ❑Duplex ❑Multi Family ❑Rental Commercial ❑Industrial
FUEL r5d Gas DElectric ❑Solid SYSTEM ❑New Viteplace
❑Oil El Solar ❑Other
TYPE
❑Forced Air DRadiant El Steam DA/C ❑Vent DElectric ❑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 DDirect Vent ❑Other
HEAT LOSS DAs Approved DExisting ❑Not Applicable
BTU RATE DAs Per Plan DVariable ❑Other Value
DESCRIPTION / SCOPE OF ALL WORK BEING DONE
//7s 4 �/n /? rc'
VALUE (Including labor and materials) $ //6()0
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07/07