HomeMy WebLinkAbout0152205 - HVAC (new return duct) 0 CITY OF OSHKOSH No 152205
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 913 BISMARCK AVE Owner CLAYTON JEMONS Create Date 09/10/2012
Contractor OWNER _ Category 500-Residential-Heating&Ventilating Plan
Inspector Jerry Fabisch
Fuel ✓Lj_Gas LED it ] I f Electric Solar
Q Solid _
System [] New j [j Replace •i
Other
Er Forced Air J Radiant liffeam I ETA& J Vent
J
Lj Electric I Li Hot Water ] f Suppl. -' U Con. Burner 1
Chimney Type 0-Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss 0 As Approved O Existing • Not Applicable Value
BTU Rate l0 As Per Plan O Variable • Other I Value
Use/Nature SFR/new heat run from basement to second floor bedroom/also new return duct to basement for second floor bedroom
of Work
I
Fees: Valuation $400.00 Plan Approval _ $0.00 Permit Fee Paid $25.00
Issued By: Date 09/10/2012
Permit Voided I Parcel Id#0604850000
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 • ' . = an ecess-• approvals before starting such activity.
i _,
Signatur=
Date ( —/"0--/ --
Agent/Owner
Address OSHKOSH WI 54901 -0 Telephone Number
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 1 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OJHKOJH
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
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 (1
**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.
)2 DATE
J /2
JOB ADDRESS ` 1 �- vlc (e ILK-
OWNER C—t°ti-Ci/�E y` ��.�.t�'f�t 5
CONTRACTOR d w(t r
CHECK!a ALL APPLICABLE
USE CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL MGas DElectric ❑Solid SYSTEM ❑New ❑ReplaCe
❑Oil ❑Solar IS Other / C� R.-u& 1�or g icc4-'(
TYPE
61`Forced Air DRadiant ❑Steam DA/C ❑Vent DElectric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED J No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B Direct Vent ❑Other
HEAT LOSS DAs Approved DExisting ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION I SCOPE OF ALL WORK BEING DONE /Vey 1-71ee ibt -Tr- b is e.ne--n--f
loo Yfooe d G- ,'i-e - c e/i 4 " 44 IP bit li e
VALUE(Including labor and materials) $ b96.
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
07/07