HomeMy WebLinkAbout0154059-HVAC (furnace) CITY OF OSHKOSH No 154059
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1121 JEFFERSON ST Owner LISA M DREW Create Date 12/28/2012
Contractor MARK WEBER HEATING&COOLING IN Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel 0 Gas Oil Electric Solar Solid
System New _ ❑✓ Replace ❑ Other
j Forced Air I Radiant ❑ Steam ❑—A/C ❑ Vent
Li—Electric ❑ Hot Water ❑ Suppl. atin. Burner
Chimney Type ChimneyA 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved O Existing • Not Applicable Value
BTU Rate As Per Plan 0 Variable • Other Value
Use/Nature SFR/REPLACE EXISTING FURNACE, ELECTRICIAN IS SECKAR ELECTRIC "debit acct
of Work
Fees: Valuation $2,600.00 Plan Approval $0.00 Permit Fee Paid $49.00
Issued By: a,. i /i Date 01/02/2013
❑ Permit Voided Parcel Id#1003580000
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 1075 ISLAND ESTATE CT OSHKOSH WI 54901 -1341 Telephone Number 235-1523
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.
12/27/2012 20:20 FAX X001
City of Oshkosh
Division of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 0.JH<OJH
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 permits)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
1 o are a .ntra for . • 'ci.a 'n_ In 4 - Perilit ee , ccount • st- and ave 'de uat u •s check here
i ,a .nt chi . .roc red thr• -h r acc. .nt r.r1
**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. l n
DATE // A 2 /t?—
JOB ADDRESS /760?/ Len CDA)
OWNER 2. / 14 Qr} i
CONTRACTO
CHECK Ell ALL APPLICABLE
USE CATEGORY
j Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL $ as - DElectric El Solid SYSTEM ONew , Replace
DOH OSolar ❑Other
TYPE
IZPorced Air ❑Radiant ❑Steam ❑A/C ❑Vent DElectric OHot Water ❑Suppl. ❑Con.Burner
IS CHIMNEY BEING LINED MD ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE OChimney A ❑Chimney B ,(Direct Vent ❑Other
HEAT LOSS DAs Approved ❑Existing DNot Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE/27_ i G -& /s7-74'6
1 .1_ • . .rte ..t i_Aar,
VALUE(Including labor and materials) '. / .rd,OCR
ELECTRICAL CONTRACTOR(for projects not requiring an ETV Form)
o7/o7
Received Time Dec. 27. 2012 8: 12PM No. 1992