HomeMy WebLinkAbout0146383-HVAC (a/c) 0 1 CITY OF OSHKOSH No 146383
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1031 PARK RIDGE AVE Owner MR/MRS DAVID J FISCHER Create Date 06/15/2011
Contractor MARX MECHANICAL Category 501 - Residential -Air Conditioning Plan
Inspector John Zarate
Fuel J Gas U Oil a Electric J Solar U Solid
System E New 0 Replace Other
J Forced Air u Radiant J Steam ✓j A/C _I Vent
Li Electric U Hot Water Suppl. 1 1 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 / REPLACE 3 TON NC UNIT, EIV SIGNED BY THE OWNER (David Fischer) * *check #5902
of Work
Fees: Valuation ( $2,800.00 Plan Approval $0.00 Permit Fee Paid $52.00
Q
Issued By: U / 1� Date 06/15/2011
a ❑ Permit Voided Parcel Id # 1222500000
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 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920 - 235 -6510
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.
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City of Oshkosh
Division of Inspection Services
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P.O. Box i 1.4
WI
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236-5084 Jj \ \HI
O/
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ON THE
WATER
HVAC PERMIT APPLICATION
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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 partickatink in the Permit fee Account System and have adequate funds, check here
if you 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. ff
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DATE Cl ' 3- a
JOB ADDRESS /0 3/ Pi t -wc- Ac'
OWNER 1J &VIC T J e l SC(f YL
CONTRACTOR III zx H -( N( (pc. /NC
CHECK 0 ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ]Electric ❑Solid SYSTEM ❑New Ankeplace
DOH ❑Solar ❑Other
TYPE
❑Forced Air ❑Radiant ❑Steam ,gA /C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
• IS CHIMNEY BEING LINED gNo [Wes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
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CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ElOther
HEAT LOSS DAs Approved ❑Existing ,ENot Applicable
BTU RATE DAs Per Plan ❑Variable Other Value
D SCRIPTION / S OPE OF ALL WORK BEING DONE
L 8 � Vv 7)-( (eV/VW Mt_ /3/106- 0 3G 3 LIAtl r
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p� `+ (.3
VALUE (Including labor and materials) $ c1 l) V
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) 6 U 6ti'kL`
07/07
City of Oshkosh
o Inspection Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903 -1130
Of -9C01H Office 920 -236 -5050
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ON 1141 wnu Fax 920 -236 -5084
Electric Installation Verification
1 (We) D ui0 ` � rISC t��
(Electrical Contractor Name or Homeowner's Name)
1 G f 1 IL IL I — e - P\VE OS fv o S4-v ir\./ I S Q 1
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
(Address' where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
x - Reconnection or new circuit for replacement Heating Plant and /or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
• Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
• electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi -use building would'require a licensed Electrical
Contractor. •
Other
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The value of this work is $ Iv [
1 hereby verify this work will be performed in compliance with the License requirements of
Section 11 -22 of the Oshkosh Municipal code and further verify the reconnection / installation
will be done in compliance with manufacturer and Electric code requirements.
t — - (p — (
(Signature of Company Officer or Homeowner) (Print Name) (Date)
07/07