HomeMy WebLinkAbout0152889 - HVAC (replace boilers) C.) CITY OF OSHKOSH No 152889
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1331 HIGH AVE Owner RIVER VALLEY CHURCH INC Create Date 10/10/2012
Contractor CHRISTENSEN HEATING&A/C INC Category 510-Ind.&Comm-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas ❑ Oil_ Electric J Solar U Solid
System n New J Ti Replace ❑ Other
Forced Air j Radiant J Steam J A/C _� Vent
Electric J Hot Water U Suppl. LJ Con. Burner
Chimney Type 0 ChimneyA 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss O As Approved 0 Existing • Not Applicable Value
BTU Rate As Per Plan O Variable • Other Value
Use/Nature OMM/REPLACE(3)BOILERS **check#62877
of Work
Fees: Valuation t 32,000.00 Plan Approval $0.00 Permit Fee Paid $345.00
Issued By: 05. ' " Date 10/10/2012
❑ Permit Voided Parcel Id#1202750000
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 1609 W WISCONSIN AVE APPLETON WI 54914 -3274 Telephone Number (920)731-3002
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)236-5050 �� ! SAT (I Fax (920)236-5084
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account I
**Advisory-For applicable projects, an Electrical Installation Verification(ETV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE IDA-iii o�
JOB ADDRESS 133 1 }-hgh �t
OWNER R,v �� i 0.h l.�--i{-
CONTRACTOR t wi* t ,i ? 7/1C
CHECK m ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex OMulti-Family ❑Rental )(Commercial ❑Industrial
FUEL 6XGas DElectric ❑Solid SYSTEM ❑New Replace
❑Oil ❑Solar ❑Other
TYPE
❑Forced Airtadiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS DAs Approved ❑Existing :Not Applicable
BTU RATE DAs Per Plan OVariable ❑Other Value
SCRIPTION/S O E OF ALL WORK BEING DONE
VIOL ) 0
(Including labor and materials)$ 3a , .°U
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
07/07