HomeMy WebLinkAbout2013-HVAC (a/c) E
� CITY OF OSHKOSH No 155646
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 924 WASHINGTON AVE Owner THOMAS KELLY Create Date 05/13/2013
Contractor DRUCKS PLUMBING&HEATING CO IN( Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuei Gas Oil ✓ Electric Solar �Solid I
System �✓ New � � Replace I � Other �
Forced Air � Radiant Steam ✓ A/C � Vent I ;
Electric Hot Water Suppl. Con. Burner
Chimney Type ChimneyA 0 Chimney B 0 Direct Vent � NotApplicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan 0 Variable � Other Value
UselNature FR/INSTALL NEW DUCTLESS A/C SYSTEM *'debit acct
of Work
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Fees: Valuati n $9,000.00 Plan Approval $0.00 Permit Fee Paid $158.00
Issued By: Date 05/15/2013
❑ Permit Voided I Parcel Id#1100480000
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 3
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 314APPLETON ST MENASHA WI 54952 -2318 Telephone Number 920-426-2654
s
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 Inspedion Services - . • �
Y.O.Box 1130 �
Oshkosh;WIS4903-1130
Phone(920)236-SO50
Fax c92�,236-5�84 H C H
QN TN \ypTFR
HVAC PERMIT APPLiCATiON
All informadon after bold categories must be provided.
Incomplete applicaLions will not be processed.
• Application(s)and fee(s)can be brought to Ciry 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$100.00 plus the
normal permit fee,which ever is greater.
OR
ar ra r rt' 1 ln Ih Permit e ec unt t m huve u e a[e s ck h
**Advisory-For applicable projects, an Electricai Installation Yerificatioa(EI�form,signed by the Electricai
Contcactor or I3omeowner(for installations allowed to be perfomied by the homeowner)mnst be submitted
with the petmit aQplication. Applications sabmitted withont an EIV whea such is nqaired,will not be
proeessed for Permit Issnc�nce and will be retnrned for completioa.
� DATE S'I Q �/,3
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OWNER T/�'1 11 e 1/V
CONTRACTOR Dr��i�s '
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CHECK�ALL APPLICABLE
USE CATEGORY
Q9Single Family ClDuplex �Multi-Farnily �Rental .C1Commercial ❑Industrial
FUEL ❑Gas (�ilElectric ClSolid SYSTEM 'ONew OReplace
❑Oil ❑Solar ❑Other `
TYPE '
❑Forced Air ORadiant ❑Steam Jf�IA/C OVent �Electric �Hot Water OSuppl. OCon.Bumer
IS CHIMNEY BEING LINED❑No OYes -LINER SIZE &MANiIFAC1'URER
Notc:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE OChimney A ❑Chimney B �Direct Vent �Other
HEAT LOSS ❑As Approved OExisting ❑Not Applicable
BT'U RATE OAs Per Plan DVariable ❑Other Value
DESCR[P?lON/SCOPE OF ALL WORK BEING DONE Zn Sf�l/ 11 t w � k ct)cS,,,�
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VALUE(lncluding labor and materials)$ 9,OD�
ELEGTRICAL CONTRACTOR(for praJects not requiring sa EIV Form)
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