HomeMy WebLinkAbout0155861-HVAC (furnace & a/c) � CITY OF OSHKOSH No 155861
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1935 WHITE SWAN DR Owner COLLEEN BRADLEY Create Date 05/22/2013
Contractor CHRISTENSEN HEATING&A/C INC Category 502-Residential-Both Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric � Solar Solid
�_-1 �--- -i
System � New � �✓ Replace ; � Other
� Forced Air Radiant Steam ✓ A/C i Vent '
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Electric Hot Water Suppl. � Con. Burner l', :
Chimney Type ChimneyA � Chimney B � Direct Vent 0 NotApplicable I
HeatLoss AsApproved � Existing � NotApplicable Value
BTU Rate � As Per Plan � Variable � Other Vatue
Use/Nature FR/REPLACE FURNACE AND A/C "check#63796,63827 �
of Work !
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Fees: Valuation $5,300.00 Plan Approval $0.00 Permit Fee Paid $110.00
Issued By: ��(,�-� Date 05/29/2013
� Permit Voided � Parcel Id#1523810000
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 1609 W WISCONSIN AVE APPLETON WI 54914 -3274 Telephone Number (920)731-3002
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 Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-]130
Phone(920)236-5050
Fax (920)236-5084 Of�K��
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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$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participatinQ in the Permit fee Account Svstem and have adequate funds check here
if vou want this processed throu�h vour account n
**Advisory-For applicable prcjec*.s, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted withont an EIV when snch is reqaired, will not be
processed for Permit Issuance and will be retarned for completion.
DATE� � I
JOB ADDRE S I�.�� I� I I�1 � ��.�, � REC�IVE�
OWNER � � � �` `
CONTRACTOR �-49= �-►5�h y- . � �7� MAY 2 0 2013
llEPART�1E\T OF
CHECK[�ALL APPLICABLE CO�I�IUViTY'DEVELOP:NEVT
iNSPECTfO�SER�'ICES Di�'1SIOV
USE ATEGORY
mgle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL L�7Gas ❑Electric ❑Solid SYSTEM ❑New 01�eplace
❑Oil ❑Solar ❑Other
T�orced Air ❑Radiant ❑Steam E'lA/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED BNo ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE �Chimney A ❑Chimney B �rect Vent ❑Other
HEAT LOSS ❑As Approved C�Existing ❑Not Applicable
BTU RATE Ca'As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF L WORK BEING DONE
L�.�L.�' �-� ���� SJ�--� (���
VALUE(Including labor and materials)$ C�V �
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ��(�((J►�
o�/o� :