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Home My WebLink About0155674-HVAC (furnace & a/c) � CITY OF OSHKOSH No 155674 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 510 CONGRESS AVE Owner JOLENE A KORNAS Create Date 05/16/2013 Contractor BLACK-HAAK HEATING Category 502-Residential-Both Plan Inspector John Zarate Fuel ✓ Gas Oil Electric Solar � Solid � System � New � �✓ Replace � � Other I ✓ Forced Air Radiant Steam ✓ A/C Vent Electric Hot Water Suppl. Con. Burner Chimney Type ChimneyA 0 Chimney B � Direct Vent � NotApplicable Heat Loss As Approved 0 Existing � Not Applicable Value _ BTU Rate As Per Plan 0 Variable � Other Value Use/Nature FR/REPLACE FURNACE AND A/C,ELECTRICIAN IS ALVIN RUSCH "check#4764 of Work I I �I i i I _—� Fees: Valuation $5,900.00 Plan Approval $0.00 PermitFee Paid $110.00 Issued By: Date 05/16/2013 ❑ Permit Voided � Parcel Id#1208760000 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 PO BOX 7075 APPLETON WI 54912 -7075 Telephone Number 920-757-9990 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. �ZECEIVED City of Oshkosh Division of Inspection Services MAY 16 2013 � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 DEFART�IIE:�T OF Fa7t (920)236-5084 C0�1�tU\ITY D£VELOPDIE: '�—�O � INSPECTIOti S£R�'iCES Dl�'IS� �—'� ON THF WATFR � 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 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 participating in the Permit fee Account Svstem and have adequate funds. check here if you want this nrocessed throu�your 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)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. DATE S-I S- I 3 JOB ADDRESS .�l D �cSYlq�'P_`,S {�'U�. OWNER d�I�ZI'le. '�DYViG�S CONTRACTOR ��OlC6c- �,I� �pLl�]r'1 q � �G . : CHECK�ALL APPLICABLE US�CATEGORY [��Single Family ODuplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL G�Gas C3�lectric ❑Solid SYSTEM ❑New C�I e lace ❑Oil ❑Solar ❑Other T� — / C�'Forced Air ❑Radiant ❑Steam G�/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner IS CffiMNEY BEING LINED �io ❑Yes -LINER SIZE &MANUFACTURER ' Note:All chimneys shall be sized per the BTCT's being vented. CffiMNEY TYPE OChimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS ❑As Approved ❑Existing �Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value DESCRIPTION/SCOPE OF ALL WORK BEING DONE �-�QS Fu�nACQ �- �'K'_ v��Jar�,mp.rrE � VALUE(Including labor and materials)� �� ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ��Y1 �(,(,cSC�'1 � �c�08� /�ervh�f ��e ' � ��o,� o��o� ,. • City of Oshkosh Division of Inspection Services � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 Fax (920)236-5084 n(�1K 1H �� ON THF WATFR � ELECTRICAL 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 permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR I�vou are a contractor participating in the Permit Fee Account Svstem and have adeguate funds, check here if vou want this processed through vour account ❑ DATE S-I S- I 3 JOB ADDRESS SI U l�o Y�qf'PSS A�IJ-e. OWNER� D I.��'LF� �D VV1Gl S CONTRACTOR �(QC�C- �CtcC�C QQ�I'l?Q � cI�C - CHECK 0 ALL APPLICABLE USE CATEGORY C�3'Single Family ❑Duplex OMulti-Family ❑Rental ❑Commercial ❑Industrial SERVICE ❑New ❑Temporary TYPE ❑Overhead �ot Applicable �Change C��t Applicable ❑Underground FII.L IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / Receptacles# Circuits# Phase Amps Switches# Fiztures# CHECK�ALL APPLICABLE ❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater ❑Fan OR Blower �nrnace C��C ❑Electric Sign : ❑Motors ❑Gas Pumps ❑Other . DESCRIPTION OF ALL WORK BEING DONE �kc-r-►��a_I � -F�a�e �rrrl � ►��la.c�rne�-r� VALUE(Including labor and all materials including light fixtures)$ �(>O-� MASTER ELECTRICIAN�1 V�n �SG�7 � �a'I D��0 p�evrn;�� 'e� �/� 3,02