HomeMy WebLinkAbout0156132-HVAC (furnace & a/c) � CITY OF OSHKOSH No 156132
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 932 EVANS ST Owner EMILY J KLASKE LIFE ESTATE Create Date 06/12/2013
Contractor MARX MECHANICAL Category 502-Residential-Both Pian
Inspector John Zarate
Fuel ✓ Gas Oil � Electric � Solar Solid
System � New � ✓ Replace � � Other I
✓ Forced Air � RadiaM Steam ✓ A/C Vent i
Electric � Hot Water � Suppl. j Con. Burner
Chimney Type � Chimney A � Chimney B � Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate p As Per Plan � Variable � Other � Value
Use/Nature SFR/Replace furnace and A/C.
of Work
Check#10426
� I
Fees: Valuation $4,975.00 Plan Approval $0.00 PermitFee Paid $94.00
Issued By: � Date 06/12/2013
❑ Permit Voided I Parcel Id#1108580000
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 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920-235-6510
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type ot
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.
t
City of Oshkosh
Division of Inspection Services ��
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 �_�`�.!i
o�v r f wArEe
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$100.00 plus the
normal permit fee,which ever is greater.
OR
I�vou are a contractor participatinQ in the Permit fee Account Svstem and have adeguate funds, check here
if vou want this Drocessed throuQh vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be sabmitted
with the permit application. Applications snbmitted withont an EIV when such is reqnired, will not be
processed for Permit Issnance and will be retamed for completion.
DATE lfJ�—�-�
JOB ADDRESS � �� L V� �I �S Sr
OWNER '`�l�-y ��1�� REC�IVED
CONTRACTOR ���1C Ml.����l�-� �I�I C�'
JUN 12 2013
CHECK 0 ALL APPLICABLE
DEPARTAIE�7 0F
USE CATEGORY C0�1�IUNITy DE�'ELOP�1EVT
`�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial INSP667'nQ.VI'�SER`ICeS DR'iSIOV
LJ1 Q STI'ldl
FUEL �as �Electric ❑Solid SYSTEM ❑New I�Replace
❑Oil ❑Solar ❑Other
TYPE
�'orced Air ❑Radiant ❑Steam �A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
IS CHIMNEY BEING LINED ❑No �Yes -LINER SIZE `�&MANUFACTURER ���
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B [$LDirect Vent ❑Other
HEAT LOSS ❑As Approved C�Existing ❑Not Applicable :
BTU RATE ❑As Per Plan ❑Variable fPOther Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ��U�C �-' FL�I�,'I�L� � A'��—
c..� c� ,
VALUE(Including labor and materials)$ l��� '
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o�/o�