HomeMy WebLinkAbout0151520 - HVAC (replace AC) C-1) CITY OF OSHKOSH No 151520
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2329 JACKSON ST Owner ARLENE M HIBSCH Create Date 08/03/2012
Contractor MARX MECHANICAL Category 511 -Ind.&Comm-Air Conditioning Plan
Inspector John Zarate
Fuel U Gas I I Oil J u Electric I Solar I Solid
System ❑ New i 0 Replace 1 n Other
J Forced Air J Radiant J J Steam ✓) NC J Vent
J Electric Hot Water j Li Suppl. U Con. Burner
Chimney Type O Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss D As Approved O Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable 0 Other Value
Use/Nature COMM/REPLACE 2-1/2 TON NC UNIT '"`check#9769
of Work
Fees: Valuation 2,600.00 Plan Approval $0.00 Permit Fee Paid $49.00
Issued By: gm Date 08/03/2012
❑ Permit Voided Parcel Id#1219700000
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.
City of Oshkosh
Division of inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5051)
Fax (920)236-5084 OOf! I
ON Mil 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$100.00 plus the
normal permit fee,which ever is greater_
OR
-if Yon are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed ihrouzh your account 11
4'Advisory-For applicable projects,an Electrical Installation Verification(EIV)form,signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an El's'when such is required,will not be
processed for Permit Issuance and will be returned for completion.
DATE g_ ( / --
JOB ADDRESS C 3-: Jae S OIN1 S
OWNER if t (S SC'I( f<< t-- Co
CONTRACTOR MARX MECHANICAL INC
CHECK El ALL APPLICABLE
USE CATEGORY
DSingle Family °Duplex fllviu ti Family ['Rental EiCommereial iJlndustrial
FUEL °Gas 'Electric DSoiid SYSTEM DNew l Replace
00i1 ❑Solar DOther
TYPE
DForced Air °Radiant L]Steam MAIL OVent DElectric °Hot Water DSuppl. DCon_Burner
IS CIII112NEY BEING LINED I (No DYes -LINES S17.E &MANUFACTURER
Note:All chimneys Shall be sized per the BTU's being vented.
CHIMNEY TYPE DClurnney A DChimney B 1 Direct Vent ' DOther
BEAT LOSS ` DAs Approved ElExisting [Not Applicable
BTU RATE DAs Per Plan DVariable f Otber Value a (a- N(
DESCRIPTION I SCOPE OF ALL WORK BEING DONE
0-(^�B w
VALUE(Including labor and materials)$ l L U ,
El ECTRICAL CONTRACTOR(for projects not requiring an LW Form)
07/07
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