HomeMy WebLinkAbout0145980-HVAC 0 CITY OF OSHKOSH No 145980
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 826 BISMARCK AVE Owner KEVIN UELAINE SCHOUTEN Create Date 03/24/2011
Contractor RYF HEATING & A/C INC Category 500 - Residential- Heating & Ventilating Plan
Inspector Nicole Krahn
Fuel U Gas U Oil U Electric Li Solar U Solid
System ❑ New 1 f] Replace j n Other
Li Forced Air u Radiant u Steam a A/C u Vent
U Electric U Hot Water U Suppl. U Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature SFR / MOVE SUPPLY & RETURN AIR RUNS **check #17040
of Work
Fees: Valuation $700.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: [Y 1 �+ Date 05/19/2011
O ❑ Permit Voided I Parcel Id # 0604960000
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 460 WINNECONNE WI 54986 -450 Telephone Number 920 - 582 -4451
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
Division o
on of Inspection Services
P.O. Box
Oshkosh, WI WI 54903-1130
Phone (920) 36 0
084 <Of
Fax x (920)236 -5-5084
ON TMF wATFR
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 IT
** 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.
DATE �- 11
JOB ADDRESS 1026 13 r s y, /4-V
OWNER kr.V s4,
CONTRACTOR ey/ it I,,.�- ,,,�-C r/.JG
CHECK El ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas DElectric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ' her $ ' �/ ' l i - /2r T
TYPE
❑Forced Air DRadiant ❑Stearn. DAIC ❑Vent ❑Electric DHot 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 DOther
HEAT LOSS DAs Approved DExisting ❑Not Applicable
BTU RATE DAs Per Plan :Wadable DOther Value //��
DESCRIPTION / SCOPE OF ALL WORK BEING DONE r , . s,� /, �- /�c /-, �, lC ,
VALUE (Including labor and materials) $ 7r w. 0 Q
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07/07