HomeMy WebLinkAbout0155997-HVAC � CITY OF OSHKOSH No 155997
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2009 JACKSON ST Owner STD PROPERTIES LLC Create Date 05/10/2013
Contractor INDOORAIRE SYSTEMS INC Category 512-Ind.&Comm-Both Plan Z4-3738-0413H
Inspector
Fuel ✓ Gas Oil Electric Solar Solid �
System �✓ New � � Replace j Other '
�-- I
✓ 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 � Variable � Other Value
Use/Nature OMM/FAST N EASY PAWN SHOP/Tenant Alterations per the approved plans. ;
of Work
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Fees: Valuation $32,000.00 Plan Approval $300.00 Permit Fee Paid $728.00
Issued By: Date O6/05/2013
❑ Permit Voided I Parcel Id#1219090000
In the performance of this work,I agree to perform ali 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 app�ication within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to se�n ne ssary approvals before starting such activity.
Signature /�.�----�.. Date —J'(-�
Agent/Owner
Address W8228 STATE HIGHWAY 54 SHIOCTON WI 54170 -9166 Telephone Number (920)470-1668
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 54903-1130
Phone(920)236-5050
Fau (920)236-5084 01HKOlH
ON THE WATER ��.
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$100.00 plus the
normal permit fee,which ever is greater.
OR
�vou are a contractor narticinatinQ in the Permit jee Account Svstem and have adeauate funds check here �
lf vou want this processed throu�votrr account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Con�actor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted without an EIV when such is required, will not be
processed for Permit Issuance and will be retarned for completion.
f DATE O � S l 1 �
JoB Ann�ss �6�Q � (�GG���
OWNER S��L� /._/��c�z f'�
CONTRACTOR �V,�sJZ ` - ��o�/1S Zj� _3� ��_ oy I?� _�
CHECK�ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi-Family ❑Rental �"Commercial ❑Industrial
FUEL �Gas ❑Electric ❑Solid SYSTEM New �Replace
Oil ❑Solar �Other
TYPE
l�Forced Air ❑Radiant ❑Steam L�A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
/�
IS CHIMNEY BEING LINED�1No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE �/S`'��I/ f�����/ � �LG?��/�
VALUE(Including labor and materials)$ �����
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
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