HomeMy WebLinkAbout0144145-HVAC C .) CITY OF OSHKOSH No 144145
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1300 S KOELLER ST Owner SHOPKO SPE REAL ESTATE LLC Create Date 11/09/2010
Contractor ROBINSON HEATING & COOLING INC Category 510 - Ind. & Comm - Heating & Ventilating Plan 08- 3188 -1110
Fuel J Gas J Oil J Electric J Solar n Solid
System n New ❑ Replace n Other
121 Forced Air J Radiant u Steam U NC ❑ Vent
Li Electric Li Hot Water U Suppl. ❑ Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • 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 HVAC ductwork for the Quick Care clinic as per plans - NO STRUCTUAL CHANGES.
of Work
Fees: Valuation $9,318.00 Plan Approval $0.00 Permit Fee Paid $150.00
Issued By: oil-N.4/ Date 11/18/2010
❑ Permit Voided I Parcel Id # 1308500100
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 PO BOX 5905 DE PERE WI 54115 - 5905 Telephone Number 920 -490 -3394
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 - Inspection Services Division - HVAC Permit Application Page 1 of 2
Division of Inspection Services
CITY Of 215 Church Avenue
L �� -�- P.O. Box 1130
Oshk WI 54903 -1130
T' _ k Fax (920) 236 -5084
OM THE WATER Phone (920) 236 -5050
HVAC PERMIT APPLICATION
All information with * next to it 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.
If vou are a contractor participating in the Permit Fee Account System and have adequate funds. type YES if
vou want this processed through your account
** 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.
* _ . i 30 � $ �-- R E C E I V E D
70B ADDRESS NOV 1 8 2010
*OWNER S i , p)4 54 DEPARTMENT OF
*CONTRACTOR g N£,„/:,,, ¢ C� COMMUNITY DEVELOPMENT
p(?. '�Sa,v INSPECTION SERVICES DIVISION
*USE CATEGORY 6r8-- 3 ! ee- / /10
0 Single Family Q Duplex 0 Multi- Family 0 Rental ((Commercial 0 Industrial
FUEL
El Gas [] Electric [Solid DOH 0 Solar
*SYSTEM
Q New 0 Replace &Other
TYPE
Forced Air fl Radiant E Steam D A/C 1 Vent E Electric fl Hot Water 0 Suppl. 0 Con. Burner
1 *IS CHIMNEY BEING LINED
http: / /www.ci.oshkosh.wi.us/ community _development /Inspections /Permit App_HVAC.aspx 4/28/2010
City of Oshkosh - Inspection Services Division - HVAC Permit Application Page 2 of 2
O Yes *No
- Liner Size: Manufacturer:
CHIMNEY TYPE
0 Chimney A 0 Chimney B 0 Direct Vent 0 Other
HEAT LOSS
0 As Approved 0 Existing 0 Not Applicable
BTU RATE
0 As Per Plan O Variable
Other:
*DESCRIPTION OF ALL WORK BEING DONE
fqS-, °Are & ,'jc./ o D u c ii1 o rE v.c) /
*VALUE (Including labor and all materials including light fixtures)
q 3/x 0
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
Submit Reset
http: / /www.ci.oshkosh.wi.us/ community _development /Inspections /Permit App_HVAC.aspx 4/28/2010