HomeMy WebLinkAbout0156190-HVAC (furnace & a/c) {
� CITY OF OSHKOSH No 156190 ";
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER �
€
Job Address 1185 TIMOTHY TRL Owner RONALD/RHONDA GRONOWSKI Create Date O6/14/2013
Contractor E C MERRILL INC Category 502-Residential-Both Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric � Solar Solid
System � New I � Replace I � Other I
✓ Forced Air Radiant Steam � ✓ A/C I Vent �
Electric Hot Water Suppl. Con. Burner !
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable
Heat Loss As Approved 0 Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature SFR/Replace furnace and A/C
of Work
"*check#012057*"'•
,
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Fees: Valuation $6,587.00 Plan Approval $0.00 PermitFee Paid $126.00
Issued By: �o� Date O6/14/2013
❑ Permit Voided I Parcel Id#1341240000
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 809 WISCONSIN AVE FOND DU LAC WI 54937 -2702 Telephone Number (920)235-3600
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.
Crty of Oshkosh �
Division oflnspection Services �
P.O. �iox ]130 �
Oshkosh,WI54903-1130
Phone(420)236-50�0
Fa� �920,���_,084 afHKO H
ON THE V✓ATER �
HVAC PERMIT APPLICATION
All infonnation after bold categories must be provided.
Incomplete appiications will not be processed.
• Application(s}and fee(s)can be brou�ht to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh Wt 54903-]128. Commencing work�vithout permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
Ij>>ou are a contractor participati�t� in the Perntit fee Account Svste�rl and have adequute funds. clreck here
ij you N�ant this processed t11r•nrreh votrr accoirnt n
**Advisory-For applicable projects, an Electrieal Installation Verification{EI�form, signed by the Electrical
Contractor or I3omeowner(for installations allowed to be performed by the homeowner)rnust be submitied
with the permit application. Applications submitted without an EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE �°��O /3
.roB AnnuFSS //�5�l�iG7,6��/ T�'�/L RECEIVED
owNEx ��.�1 G'�'o,�/or�vS,C/ JUN 13 2013
CONTRACTOR L.C� „�Gf��Q/�l�L ��� •
DEPARTAIE�T OF
CO�1�tUNiTY[�E!'£LOP�fE.VT
CHECK 0 ALL APPLICABLE 1NSPECTIO�S£R1'ICES D(�'iS10V
USE CATEGORY
JS(Single Family ❑Duplex ❑Multi-Pamily ❑Rental ❑Commercial ❑Industrial
' FUEL J�Gas ❑Electric ❑Solid SYSTEM ❑New �jReplace
OOiI �Solar ❑Other `
TYPE
�Forced 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 ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved �Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIP ION/SCOPE OF ALL WORK BEING DONE
� �� ,v ,�°i��
VALUE (Including labor and materials) $ �p� J'r��•� ��: �� .�
�LECTRICAL CONTRACTOR(for projects not rcquiring an E1V Form) �j�fL�/fJjj�jj�(� ���