HomeMy WebLinkAbout0155759-HVAC (furnace) � CITY OF OSHKOSH No 155759
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1528 GROVE ST Owner STEVEN J/SARA E ELIASEN _ _ Create Date 05/20/2013
Contractor DRUCKS PLUMBING&HEATING CO INC Category 500-Residential-Heating 8�Ventilating Plan
_ ._ _ ___
Inspector John Zarate
Fuel ✓ Gas Oil Electric
Solar � Solid __ _
System ❑ New I �✓ Replace j � Other j
✓ Forced Air Radiant Steam A/C Vent �
� Electric Hot Water Suppl. Con.Bumer
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan 0 Variable � Other � Value
Use/Nature FR/REPLACE EXISTING FURNACE **debit acct
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of Work
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Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: �� Date 05/22/2013
❑ Permit Voided Parcel Id#1511560000
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 314APPLETON ST MENASHA WI 54952 -2318 Telephone Number 920-426-2654
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 oFOshkosh •
Divislon oFlnspection Services • ' �
P.O.Box 1130 �
Oshkosh;W154903-1130
Phone(920)236-SU50
Fax (920)236-5084 �--{
ON T4F 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 lnspection Services,PO Box 1128,
Oshkosh Wl 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR _
1 r o c c1 r i i In ►ni� • un nd v n e uctt
o nc c ro ur c
**Advisory-For applicable pmjects, an Electrical Installation Verification(El�form,sigaed by the Electcical :
Conhactor vr Homeowner(for instalIations allowed to be performed by the homeowner)mnst be snbmitted
with the peimit application. Applicadoas snbmitted w�thout aa EIV when snch is nqnired,w�l not be .
Qrocessed for Penmit Issuance and will be reMrned for completion.
� DATE S '-�� � 13 :
�oB Ann�ss I s�t� Gro�� st
OWNER -Sa rq t ���4 Scn
COIVTRACTOR D h cu h 1
CHECK 0 AI.L APPLICABLE
USE CATEGORY
�Single Family ❑Dupl�x ❑Multi-Family ❑Rental �Commercial ❑Industrial
FUEL �Gas ClElectric ❑Solid SYSTCM ONew �]Replace
❑Oil OSolar ❑Other
TYPE
�Forced Air ORadiant OSteam OA/C OVent O�lectric DHot Water OSuppl. ❑Con.Burner
1S CHIII�INEY BEING L1tYEll ONo OYes -LINER S1ZE &MANUFACTURER
Noic:All chimncys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A �Chimney B �Direct Vent OOther
HEAT LOSS ❑As Approvcd OExisting ONot Applicable
BTU RATE ❑As Per Plan ❑Variable DOther Value
DESCRIPTION /SCOPE OF ALL WORK BEING DONE .l� S f�v/1 Ne�+/ �y��� rc, :
VALUE(Including labor and muterials)$
ELECTRICAL CONTRACTOR(tor projects not requlriog an EIV Form)_ �j 0 9 O
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