HomeMy WebLinkAbout0152618 - HVAC (replace heating and cooling system) Ci) CITY OF OSHKOSH No 152618
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 712 DOCTORS CT Owner AURORA MEDICAL GROUP INC Create Date 09/27/201.2_
Contractor ALDAG/HONOLD MECHANICAL Category 512-Ind.&Comm-Both Plan
Inspector John Zarate
Fuel ✓ Gas LI Oil J ❑ Electric ❑ Solar 1 I ] Solid
System ❑ New ❑✓ Replace I ❑ Other 1
Forced Air ] ❑ Radiant Steam 7 ❑ A/C ❑ Vent J
Electric ] ❑ Hot Water i L Suppl. ❑ Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent O Not Applicable
Heat Loss 0 As Approved • Existing O Not Applicable Value
BTU Rate 0 As Per Plan • Variable O Other Value
Use/Nature COMM/REPLACE EXISTING HEATING AND COOLING SYSTEM **check#79559
of Work
Fees: Valuation 37,247.00 Plan Approval $0.00 Permit Fee Paid $371.50
Issued By: Date 09/27/2012
❑ Permit Voided] Parcel Id#1519110000
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
e re any ne s ary approvals before starting such activity. 7--1,?
Signature /,{�L � Date q•f
Agent/Owner
Address 3509 S BUSINESS DR SHEBOYGAN WI 53082 -0 Telephone Number 920-458-5558
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
Oshkosh, WI WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 Of OJH
ON THE WATER 1
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 fl
**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.
1
-7 DATE q-025-)a.JOB ADDRESS /1 L�N Q •
OWNER f)Ur012t H ea 1 H\ Ct(IBC
CONTRACTOR A!c txj/ ,nod !I/ecJ tf1/[a( Inc
CHECK®ALL APPLICABLE
USE CATEGORY
El Single Family ❑Duplex DMulti-Family :Rental ,Commercial ❑Industrial
FUEL it ❑Electric ❑Solid SYSTEM ❑New IgiReplace
❑Oil ❑Solar ❑Other
TYPE
(Forced Air ❑Radiant ❑Steam DA/C ❑Vent ❑Electric ❑Hot Water DSuppl. ❑Con. Burner
IS CHIMNEY BEING LINED No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B Ebirect Vent ❑Other
HEAT LOSS DAs Approved QgExisting ❑Not Applicable
BTU RATE DAs Per Plan XVariable ❑Other Value
•
DESCRIPTION/SCOPE OF ALL WORK BEI, G DONE ' `.I .. I L !a
a o[ 1
Corn • r In _n my S U rnc- <Ind Tc a SrE
Fumy .( Q� Mucci ov c( / k un. 544keach,
VALUE (Including labor and materials) $ 37) a Li?
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) gi,,,.- � - I _I _
07/07