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Home My WebLink About0155830-HVAC (a/c)� � CITY OF OSHKOSH No �5ss3o � OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1504 W MURDOCKAVE Owner RACHEL D WAGNER Create Date 05/28/2013 Contractor BLACK-HAAK HEATING Category 501 -Residential-Air Conditioning Plan Inspector John Zarate Fuel Gas Oil ✓ Electric Solar Solid _J System � New � �✓ Replace _j � Other � _. Forced Air Radiant Steam ✓ A/C �Vent � I Electric � Hot Water Suppl. Con.Burner Ji Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable i Heat Loss As Approved � Existing � Not Applicable Value BTU Rate As Per Plan � Variable � Other -� Value Use/Nature FR/A/C INSTALL,WIRING DONE BYALVIN RUSCH "check#4831 of Work Fees: Valuation $3,100.00 Ptan Approval $0.00 Permit Fee Paid $78.00 J Issued By: \ 1� Date 05/28/2013 ❑ Permit Voided I Parcel Id#1217440000 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 othenivise,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 Inspection Services � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 Faac (920)236-5084 O �--�KO H 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$100.00 plus the normal permit fee,which ever is greater. OR If vou are a contractor participating in the Permit fee Account Svstem and have adeguate funds, check here i�,you want this processed through vour account (� **Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be : processed for Permit Issuance and will be returned for completion. DATE S.:.c�a�i 1TT JOB ADDRESS I SG`-f LU mt,lYC(t)(',IC., ��-I- OWNER J�ac,he J 1,�.�Za � MAY 2 4 2013 CONTRACTOR '�la r.(�- l-�aa k NO�� T�l�IC - DEYARTM11EIT OF CO�1�IU\iTY DEVELOP�tEVT CHECK�ALL APPLICABLE iNSPECTiON SERViCES Dl�'IS10V USE CATEGORY �ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL ❑Gas [$�ectric ❑Solid SYSTEM ❑New C�I�place ❑Oil ❑Solar ❑Other TYPE �� ❑Forced Air ❑Radiant ❑Steam C�'A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANUFACTURER Note:All chimneys shall be sized per the BTLJ's being vented. CffiMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value DESCRIPTION/5COPE OF ALL WORK BEING DONE 1� I,�S�1.( VALUE(Including labor and materials)$ 3, O� .� � .y� l0 ELECTRICAL CONTRACTOR(for projects not requiring an EN Form) �l v�� l,C�(�j �O� �� %t-�'YYI�"f �'�'e � l �' � o�/o� M � City of Oshkosh Division of Inspection Services � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 Fax (920)236-5084 �--�K I--� ON THF V✓ATFR 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$100.00 plus the normal permit fee,which ever is greater. OR ' �you are a contractor participating in the Permit Fee Account Svstem and have adequate funds check here i�you want thisprocessed throu�vour account ❑ DATE 5-aa-i 3 JOB ADDRESS I SZ��I l.c� V�1��.vcl o c fc �� OWNER f�,l�..( (�c�a��r�e,V CONTRACTOR��0.CP.C- �Ctct.� �.QCL�7�i2q , .TiV1C - CHECK a ALL APPLICABLE USFr CATEGORY : �ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial SERVICE ❑New �Temporary TYPE ❑Overhead B�Applicable C�}G�ange ❑Not Applicable ❑Underground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / Receptacles# Circuits# Phase Amps Switches# Fiztures# CHECK 0 ALL APPLICABLE ❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater ❑Fan OR Blower ❑Furnace � ❑Electric Sign ❑Motors ❑Gas Pumps ❑Other DESCRIPTION OF ALL WORK BEING DONE W i►�Qc� -� e-P�ta�-t�ud (�v�oa l� 1�/� VALUE(Including labor and all materials including light fiztures)$ �� MASTER ELECTRICIAN ��V1Y� `�L'.t�l � ��}�D o � J�errW��- �� ; � �. � 3�02