HomeMy WebLinkAbout0155372-HVAC � CITY OF OSHKOSH No 155372
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 304 OTTER AVE Owner OSHKOSH OTTER AVE LLC Create Date 04/29/2013
Contractor CENTRAL HEATING SERVICE INC Category 512-Ind.&Comm-Both Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric � Solar Solid __�
System � New I � Replace 'i � Other �
✓ Forced Air Radiant Steam A/C j Vent '
Electric Hot Water Suppl. Con.Burner
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
HeatLoss AsApproved � Existing � NotApplicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature OMM/HVAC REMODEL PER STATE PLAN '*check#25235,25239 ,
of Work I
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Fees: Valuation $12,360.00 Plan Approval $0.00 Permit Fee Paid $204.00
Issued By: � Date 05/01/2013
� Permit Voided I Parcel Id#0200500000
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 1565 HARRISON STREET OSHKOSH WI 54901 -3007 Telephone Number (920)235-6670
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
Fax (920)236-5084 O HKO H
ON THF WATER
HVAC PERMIT APPLICATION
All information after bold categaries 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 54903-1 1 28. 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'vou are a contractor particivatinQ in the Permit fee Account Svstem and have adequate funds, check here
if vou want this processed through vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be submitted
with the permit application. Applications submitted withont an EIV when such is reqnired, will not be
processed for Permit Issnance and will be retarned for completion.
DATE -�-� l j
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JOB ADDRESS � Q t V � ' �% Y� S �� CEIVED
OWNER :
CONTRACTOR � t:i� T✓1� L �-��� S �'� V• % ��U C , APR 2 3 2013
DEPART;�gF�T OF
CHECK�ALL APPLICABLE CO�'ru�iT�'n�;ELOPMENT
INSPECTIO�SERDtCES Dl�')g�p;�r
USE CATEGORY
�Single Family ODuplex ❑Multi-Family ❑Rental �Commercial OIndustrial
FUEL �as ❑Electric ❑Solid SYSTEM ONew ❑Replace
❑Oil ❑Solar ❑Other
TYPE
�orced Air ❑Radiant ❑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 �s Approved �xisting ❑Not Applicable
BTU RATE �sPer Plan ❑Variable �Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
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VALUE(Including labor and materials) $ ��, i 3 �fJ � � ��
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ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
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