HomeMy WebLinkAbout0152998 - HVAC (erplace AC) (13 CITY OF OSHKOSH No 152998
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2950 REBECCA RUN Owner MICHAEL R/DANICIAA HUMBERT Create Date 10/16/2012
Contractor ANDREW R MEIER Category 502-Residential-Both Plan
Inspector Nicole Krahn
Fuel Gas - I ❑Oil j ❑Electric 7
1 j Solar i ❑ Solid
System ❑ New NI Replace J ❑ Other
71-Forced Air Q Radiant -I steam 0 A/C ❑Vent J
Electric j D-Hot Water Suppl. JI ❑ Con. Burner
Chimney Type ❑ Chimney A • Chimney B 0 Direct Vent 0 Not Applicable _-I
Heat Loss /Ns Approved • Existing O Not Applicable Value
BTU Rate ❑ As Per Plan O Variable • Other 1 Value
Use/Nature SFR/REPLACE FURNACE AND A/C **check#4990
of Work
Fees: Valuation $7,454.00 Plan Approval $0.00 Permit Fee Paid - $121.00
Issued By: ❑ Date 10/16/2012
❑ Permit Voided J Parcel Id#1341110000
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 6814 ENGE DR WEST BEND WI 53090 -9571 Telephone Number (262)391-3002
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-Inspection Services Division-HVAC Permit Application Page 1 of 2
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh,WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5050
,s 1
-
HVAC PERMIT APPLICATION
All information with * next to it 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.
If you are a contractor participating in the Permit Fee Account System and have adequate
funds, type if you want this processed through your account
** 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 urned
for completion.
agS0 AI ecca d2.uv1 U� i " 2012
*]OB ADDRESS hkoS� is CJ. 4 G Oi{
DEFT
�� " l I COMMt�r��r �t-
*OWNER M i c e I �i t rn be'r-� INSPEC �1N Sc: J :_ �-
*CONTRACTOR A dre �, meter./ dAC InlS 0. Vt--(oris
(.0Q) Erloje Drive Wes-i- 'ncj, uj is 53090
*USE CATEGORY
Single Family Duplex Multi-Family Rental Commercial Industrial
FUEL
Gas Electric Solid Oil Solar
*SYSTEM
New ( Repla e) Other
` Forced
Air..„) Radiant Steam NC Vent Electric Hot Water Suppl. Con. Burner
*IS CHIMNEY BEING LINED
Yes No
http://www.ci.oshkosh.wi.us/Community Development/Inspection_Services/Permit_App ... 10/4/2012
City of Oshkosh-Inspection Services Division -HVAC Permit Application Page 2 of 2
I - Liner Size: Manufacturer:
CHIMNEY TYPE
Chimney A imney B Direct Vent Other
HEAT LOSS
As Approved xisting Not Applicable
BTU RATE
As Per Plan Variable
Other:
*DESCRIPTION OF ALL WORK BEING DONE
Race c, rncce c nct ��r Lovl ;Ptf�n �r
epl
�c°OM )/r__ C9/141/10 6.7/4/ 60,6t , l
i
le-.0/141)/v.. /_=-- A/ e,21 Ci ;Noce-D
*VALUE (Including labor and all materials including light fixtures)
A .) 4/5-`/- 00
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
Submit Reset
1/27/1
http://www.ci.oshkosh.wi.us/Community_Development/Inspection Services/Permit_ App_... 10/4/2012