HomeMy WebLinkAbout0146967-HVAC 0 CITY OF OSHKOSH No 146967
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3080 LAKE REST LN Owner JOHN G SAMSTER JT REV TRUST Create Date 06/06/2011
Contractor KURT ZENTNER & SONS INC Category 500 - Residential- Heating & Ventilating Plan
Inspector Nicole Krahn
Fuel ❑! Gas 1 1 Oil U Electric Li Solar U Solid
System ❑ New ® Replace ❑ Other
HI Forced Air u Radiant ❑ Steam u NC ❑ Vent
U Electric U Hot Water u Suppl. ❑ Con. Burner
Chimney Type 0 Chimney A O Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan • Variable 0 Other Value
Use /Nature SFR\ Addition & Remodel. Install radiant tubing and boiler for the addition. * *debit acct
of Work
Fees: Valuation $9,000.00 Plan Approval $0.00 Permit Fee Paid $145.00
Issued By: C , YID/ Date 07/26/2011
❑ Permit Voided I Parcel Id # 1415730000
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 2860 OREGON ST OSHKOSH WI 54902 - 7136 Telephone Number (920) 235 -1340
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.
6Sti9' °N VEIL paAia°4
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236 -5050
Fax (920) 236 -5084 Q/HKQIH
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
I ou are a contractor •artici•atin- in th' 'e mit -' •ccount S stem and have ade,uate unds check er-
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 ped by the homeowner) mast be submitted
with the permit application. Applications submitted without an UV when such is required, will not be
processed for Permit Issuance and will be returned for completion /
DATE �/2e4 f 2-cty
JOB ADDRESS .34 id L4 /
OWNER CO lir,
CONTRACTOR JGriiz>" 2.fi.s'
CHECK El ALL APPLICABLE
U§E CATEGORY
Single Famil DDuplex ❑Multi- Family Mental DCommercial ❑Industrial
FUEL L ,Gas - ❑Electric ❑Solid SYSTEM ONew ❑Replace
DOil ❑Solar ❑Other
TYPE
❑Forced Air padiant ❑Steam ❑A/C ❑Vent DElectric 01-lot Water CSuppl. ❑Con. Burner
IS CHIMNEY BEING LINED ONo DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized Or the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B rhirect Vent ❑Other
HEAT LOSS DAs Approved ❑Existing n Not Applicable
BTU RATE DAs Per Plan ,Variable ❑Other Value
DESCRIPTION / SCOPE OF ALL WO / RK � ► BEING DONE .Tits, /1 iae1hoo- -/
VALUE (Including labor and materials) $ q
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
07/07