HomeMy WebLinkAbout0152905 - HVAC (replace fireplace) CD CITY OF OSHKOSH No 152905
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1003 OAK ST Owner JAYNE M KLECKNER Create Date 10/11/2012
Contractor OWNER Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel TGas J EPDil ❑ Electric —I ❑ Solar [TSolid 1
System ❑ New 0 Replace ❑ Other 1
Forced Air ETRadiant TSteam TA/C H Vent
❑ Electric ❑ Hot Water i Li Suppl. ❑Con. Burner
Chimney Type 0 Chimney A ❑ Chimney B ❑ Direct Vent • Not Applicable
Heat Loss 0 As Approved ❑ Existing • Not Applicable I Value
BTU Rate 0 As Per Plan ❑ Variable • Other
Value
Use/Nature SFR/replacing wood fireplace with new insert fireplace/must follow all local and state codes/liner will be installed per manufacturer
of Work pec's
Fees: Valuation $1,750.00 Plan Approval _ $0.00 Permit Fee Paid $37.00
Issued By: ..3 Date 10/11/2012
❑ Permit Voided Parcel Id#1110020000
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 rae any necessary appro Is fore st ing such activity.
Signature ", ' `vc - Date /0 '7/-ZOJ?
C �' Agent/Owner
Address /00;3 6Gi-!C S 1_(_ OSHKOSH WI 54901 -0 Telephone Number IS`S 7Z7-9
9(‘
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 Of-KOfH
Fax x (920)236-56-5084
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account n
**Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required,will not be
processed for Permit Issuance and will be returned for completion.
DATE I0HI - Z
I
JOB ADDRESS, 1 00 3 0(,k -St-
OWNER
J z y rLQ k I6) C kv `Q C
CONTRACTOR
CHECK ill ALL APPLICABLE
USE CATEGORY
XISingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ❑Electric,14Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar 'IOther _Li�l SFr
TYPE
DForced Air ❑Radiant ❑Steam ❑A/C ❑Vent DElectric ❑Hot Water ;$(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 DDirect Vent DOther
HEAT LOSS DAs Approved DExisting ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
VALUE(Including labor and materials)$ t 1 5-0 6'v
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
0"7/07