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Home My WebLink AboutHVAC (new addition) 11/26/12) City oOofInsh Division ision of Inspection Services P.O.Box 1130 Oshkosh,WI 54903-1130 Phone(920)236-5050 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 //-'2 6 -/ 2 JOB ADDRESS 3 CS T e Sd OWNER CONTRACTOR S P 13 CHECK Ed ALL APPLICABLE USE CATEGORY ❑Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial )4Industrial FUEL Gas DElectric ❑Solid SYSTEM Slew DReplace ❑Oil El Solar ❑Other TYPE / Forced Air DRadiant ❑Steam ❑A/C ❑Vent DElectric ❑Hot Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED ❑No DYes -LINER SIZE &MANUFACTURER Note:All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE Chimney A (h-Chimney B DDirect Vent 0 Other HEAT LOSS As Approved DExisting ❑Not Applicable BTU RATE `i'As Per Plan DVariable ❑OI t fher Value DESCRIPTION/SCOPE OF ALL WORK BEING DONE 4 C Y�r z,j I VALUE (Including labor and materials) $ 1 C.P / (10 1) ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) 07/07 9 CITY OF OSHKOSH No 153698 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3555 MOSER ST Owner RONALD H/JANE K JOHNSON LLC Create Date 08/20/2012 Contractor ANDERSON HVAC LLC Category 510-Ind.&Comm-Heating&Ventilating Plan state review Inspector John Zarate Fuel [✓] Gas EFDil I Q Electric J [l Solar , Q Solid System Q New 0 Replace J 0 Other j U Forced Air Radiant Steam _I A/C I Vent U Electric DTiot Water E Suppl. Li Con. Burner Chimney Type 10 Chimney A O Chimney B 0 Direct Vent • Not Applicable Heat Loss l As Approved 0 Existing 0 Not Applicable I Value BTU Rate 0 As Per Plan O Variable O Other Value Use/Nature IND/Warehouse addition/new HVAC unit per state approved plans of Work Fees: Valuation $168,000.00 Plan Approval $0.00 Permit Fee Paid $1,025.00 Issued By: Date 11/26/2012 ❑ Permit Voided I Parcel Id#1519606400 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 secu ny necessary approvals (fore starting such activity. Signature Date .- Agent/Owner Address 3454 JACKSON ST STE C OSHKOSH WI 54901 -8143 Telephone Number 920-410-8858 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.