HomeMy WebLinkAbout0145327-HVAC #14 CITY OF OSHKOSH No 145327
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3348 MOCKINGBIRD WAY Owner CASEY'S MEADOW LLC Create Date 11/22/2010
Contractor GRANT SCHULTZ HEATING & COOLING Category 502 - Residential -Both Plan
Fuel ✓ Gas Li Oil Li Electric Li Solar I 1 Solid
System n New I ❑ Replace n Other
u Forced Air Li Radiant u Steam u NC L Vent
J Electric 1 1 Hot Water U Suppl. U Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing 0 Not Applicable Value
BTU Rate • As Per Plan 0 Variable 0 Other Value
Use /Nature NSFR/ HVAC for new quad level home with a 2 car attached garage. "'debit acct
of Work
Fees: Valuation L $5,200.00 Plan Approval $0.00 Permit Fee Paid $88.00
Issued By: �/� / Date 04/04/2011
❑ Permit Voided I Parcel Id # 1336210000
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 55 CRIMSON LN OSHKOSH WI 54902 -7298 Telephone Number (920) 216 -1616
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.
r 04 11 09:03a
City of Oshkosh Grant Schultz Htg & NC 920 237 4959 p.1
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
0
Phone (920) 236 -5050
Fax (920) 236 -5084 O,f OJH
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 particinating in the Perrnrt a Account System and have adequate funds. check here
if you wane this processed through your account
v DATE 4 / -/ —1 /
JOB ADDRESS 3 V? Mdek o gbi r/
OWNER g u s&II
CONTRACTOR & /7141 C ,-g(,/Uf 1
CHECK 0 ALL APPLICABLE
USE CATEGORY
Dingle Family ODuplex ❑Multi - Family Mental ❑Commercial DlndustriaJ
FUEL Gas ❑Electric ❑Solid SYSTEM OlialNew ❑Replace
❑Oil ❑Solar ❑Other
TYPE
orced Air ❑Radiant OSteam DA/C ❑Vent ❑Electric ❑Hot Water DSuppl. °Con. Burner
IS CHIMNEY BEING LINED 1No ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B 72Direct Vent ❑Other
HEAT LOSS - pAs Approved ❑Existing ❑Not Applicable
BTU RATE IAs Per Plan ❑Variable ❑Other Value
DESCRIPTION OF ALL WORK BEING DONE
jMw fVAC irk
VALUE (Including labor and materials) $ S c �
ELECTRICAL CONTRACTOR 0
❑ For applicable projects, an E tric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
10/04
Received Time Apr. 4. 2011 7:59AM No.5144