HomeMy WebLinkAbout0152448 - HVAC (install Ductless splite heat pump) CITY OF OSHKOSH No 152448
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3865 EDGEWOOD RD Owner DONALD C BARTZ Create Date 09/18/2012
Contractor MCM AIR INC Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ❑ Gas Li Oil ] LI Electric Solar ] ❑ Solid ]
System ❑ New ] ❑ Replace ❑ Other
Forced Air 1 _1 Radiant ] ] Steam ❑A/C Q Vent ]
❑ Electric ❑ Hot Water ] Lf Suppl. 1 Q Con.Burner
Chimney Type b ChimneyA O Chimney B 0 Direct Vent • Not Applicable
Heat Loss As Approved O Existing • Not Applicable Value
BTU Rate b As Per Plan O Variable • Other ] Value
Use/Nature SFR/INSTALL DUCTLESS SPLIT HEAT PUMP- 1 TON "check#23254
of Work
Fees: Valuation $3,0 .00 Plan Approval $0.00 Permit Fee Paid $55.00
Issued By: 1� Date 09/18/2012
❑ Permit Voided Parcel Id#1282000100
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 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number 920-582-4402
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`C6
Phone(920)236-5050 j
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 El
**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 9-/7.42
JOB ADDRESS 3- � L (
OWNER d�Gst tip
CONTRACTOR )'/y') at,t) , �ii --
CHECK H ALL APPLICABLE
USE CATEGORY
Dingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ❑Electric ❑Solid SYSTEM ONew dace
❑Oil ❑Solar ❑Other
}
TYPE y-/-fe c7 t f4 +a. 7
❑Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINEDFIiC10 ❑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 ❑Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ,of , , ` '
AIM P�GJtn p, f Tefre /7. 5-
.7. 5 .{ 'c.,L(
VALUE (Including labor and materials) $ `3QG'2c,e'er
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
07/07