HomeMy WebLinkAbout0155651-HVAC (furnace & a/c) � CITY OF OSHKOSH No 155657
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 50 JOHNSON AVE Owner ALFRED T KISUBI Create Date 04/30/2013
Contractor D 8 S HEATING AND COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel ✓Q—Gas Oil _� Electric Solar , Solid !
System � New ; �eplace [� Other _ _ _ '
✓ Forced Air Radiant Steam ✓ A/C Vent
Q J �_ _-� i
Electric Hot Water Suppl. Con. Burner �
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable
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HeatLoss AsApproved � Existing � NotApplicable Value
BTU Rate As Per Plan � Variable � Other Value :
Use/Nature FR/REPLACE EXISTING FURNACE AND A/C '"check#2017,2028
of Work I
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Fees: Valuation $8,420.00 Plan Approval $0.00 Permit Fee Paid $158.00
Issued By: /ti Y y � Date 05/15/2013
C7—' • �
❑ Permit Voided I Parcel Id#1416660100
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
AgenUOwner
Address W1418 TOWN HALL DR PULASKI WI 54162 -7517 Telephone Number (920)660-0097
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 ofInspection Services
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fa�c (920)236-5084 O �--�KO H
ON THF WATFR �
HVAC PERMIT APPLICATION :
All infor►nation 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 54903-1 1 28. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
�vou are a contractor participating in the Permit fee Account System and have adequate funds, check here
if vou want this processed throu�h vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form,signed by the Flectrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be sabmitted
with the permit applicadon. Applications submitted withont an EIV when such is reqnired, will not be
processed for Permit Issnance and will be retnrned for completion.
DATE � �� _/�
JOB ADDRES��-�!t!u'1/I.S�/1 �l/2 �
OWNER�,�P �� C j,(I�/ �
CONTRACTOR_���;�–Ly�fl� u�as l5,� ��O���
CHECK�ALL APPLICABLE
USE CATEGORY
�.Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ,�Gas ❑Electric ❑Solid SYSTEM ❑New �Replace
❑Oil �Solar ❑Other
TYPE
,�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED,J�No�Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B �birect Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WOR BE G DONE
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VALUE(Including labor and materials)$ ���� � �/ ���O�
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ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
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