HomeMy WebLinkAbout0155558-HVAC (furnace & a/c) I�''� CITY OF OSHKOSH No 155558 ;
�
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1875 ORCHARD LN Owner THOMAS B/SUSAN L KERR Create Date 05/10/2013
Contractor MARX MECHANICAL Category 502-Residential-Both Plan
Inspector Nicole Krahn
Fuel ✓ Gas Oil Electric Solar � Solid �
System � New � �✓ Replace � � Other j
✓ Forced Air Radiant Steam ✓ A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable �
Heat Loss As Approved � Existing 0 Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature FR/REPLACE 70,000 BTU FURNACE AND 2-1/2 TON A/C "check#10361
of Work I
__�
Fees: Valuation $5 00.00 Plan Approval $0.00 Permit Fee Paid $110.00
issued By: (�l Date 05/10/2013
❑ Permit Voided I Parcel Id#1310510000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenbOwner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920-235-6510
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
(�a
Division of Inspecxion Services
P.O_Box li3U -�
Oshkosh,WI 54903-1130 �
Phone(92{1)236-�t?Sfl
Fax t92o,��-sog4 �1�O1H
ON TtiF 1lATER
HVAC PERMIT APPLICATlON
Ail information a8er�1d categories must be pravided.
Incomplete app)icaiions will noT be pmncessed.
� 1�pplication(s)and fee(s)can be brought to City Hall,Room 205 or rnailecl to Inspection Services,PO Box l 128,
Oshkosh WI 54903-112$. Commeacing work wit�oui permit(sj will result in fees being doubled or$100.00 plus the
normal�it fce,which ever is greater_
. OR
f vou are a contractor narticinating in 1he Permii fee Accouni System and have adequate funds check here
f vou want thrs Arocessed rhrnugh your accou»t (1
''*Advisory-For appIirable Pi'njerts,an Elec�ical Insiallatian Ve�wtion(EIV)�onm,signed bY t�e IIecx�icaI
Co�tracbor oi Homeowner(for installations allowed#o be peifomud by th�e L�omeowner)mmst be sabmrtted
with#�re�a�plicat3ion. Appli,cabions submiitcd witiuou#an IIY when such is requ�ed,w�l not be
processed for Pcnmit Issnance and w�l be�tuu�ed for completinn.
DATE �— i"�I ,�
aoB Annx�ss � �`�S ���Ii�� ��J �E��gVE�
OWNER �r`�/��� (���
CONTRACTOR ��X MECHANICAI, 3NC MAY 0 9 2013
����0���P���� llEPARTniEO7 OF
CO�'I�IUNiTY�EVELOP�1E:VT
USE CATEGORY i�ISPECTIO��ERO'?C£S Dl�'1SlON
1�$ingle Family f�Dupiex �Multi Family C3Rentai L]�ommerciai ClIndustriai
FITEL � �Eleetric IJSoiid SYSTEM CiNew �Replace
Oil �Solar �Oti�er
TYPE
�'Forced Air flRadian# �Steam '�'A/C ClVent flElectric DHot Water OSvppl. DCo�Btuner
IS CHIiVIl�IEY BEII�TG LIl�iED LlNo'$�Yes -I,Il�iF�t SIZE 3 N 8t AdANUFACTt�R I�-�—�_
Note:All chimncys shall be sized per the BTU's being vented.
C`HIlVIl�tEY TYPE �Chimney A �Chimney B `�irect Vent � �Other
HEAT LOSS ' C3As Approved �'E�sting �1�Tot Applicabie �� ��U�\ �I�� l N n�)I
BTU RATE L7As Per Plan �Variable �Oti�er Value �
DES ON/SCOPE OF ALL'WORK BEING DONE
� � � � '� � C_ \l 1} �
`1� �`La-��l�t�u'1ox -3 � 1� ii�.� ���x� ail� �P�i
(�+� I'3{�x— 0��> � `/.� 1�r� f'�—�� �
�— U�
VA.i..UE{Including labor and materials)� ���(�� ,
�:r�G3TtICAL CONTRAGTOR(#or pr�jects not re�uiring an EIV Form) t�L� - �w N��-
o�io�