HomeMy WebLinkAbout0156257-HVAC (a/c) � CITY OF OSHKOSH No 756257
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3340 COUNTY RD A Owner MATTHEW E/BRITANY N BONEN Create Date 06/18/2013
Contractor BETTER HOME HEATING&AIR CONDiI Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel Gas Oil Electric Solar Solid
System � New � Replace I Other _�
�/ Forced Air Radiant Steam ✓ A/C i Vent
Electric � Hot Water Suppl.� Con. Bumer
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable �
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature SFR/Replace C/A
of Work i
"ck#71742""
;
Fees: Valuation _ $2,675.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: �1�.� Date 06/18/2013
❑ Permit Voided I Parcel Id#1550070000
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 1054 AMERICAN DR NEENAH WI 54956 -1305 Telephone Number 920-733-2161
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 O.lHK01H
Fax (920)236-5084 •
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
Ifvou are a contractor participatinp in the Permit fee Account System and have adequate funds check here
i�vou want this processed 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)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 `�— oZ �/v
JOB ADDRESS �3`�0 ��
OWNER��,.c.-�� � jo� �
CONTRACTOR � .
CFIECK BI ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ❑Electric ❑Solid SYSTEM �New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
❑Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHININEY BEING LINED ❑No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIlVINEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOP OF L WORK B G DONE
VALUE (Including labor and materials) $ � � ��. v6
/ '
� :
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
� � _ 9'7g 7 0��0�
May 30 2013 11 : 53RM HP LRSERJET FRXTRUMPHELE 9207343838 page 2
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Electric Inst�i�s-t�on �e�cetion
I(we) ,•
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(Eleca;cal Convactor Nam+e) :
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(Addre�s) ��? /
(Stata) (Zip Code)
have been con� � p��electric inatallation worl�for �.��,,,� �
(N�ne of party contracted to�
at the i�bllowiqg addreas: �/0
( where work will be�performed)
The n�ture ofthe work con�ists of: (Check One or Descr�be�e N��of Work)
� �. Roconnaction or Aew cireuit fur ropls�cemeart : ,
Reconn�ction o�naw circuit�or ��Plant and/or A/C Coedeua�r.
w�te�heai�. �plsc,�ta�t�l�c Water Hea�ear or pow�r vented
� Reconnection of the Se�vice Entr�noe Cable,I�rieter Box, slteraao�to
aod light�fixttu+es due to�id�/so�t�n. Note: Naw Se�rvictaeles
�tr+�c�Cab� will roq�ut+e a��rat�pe��t,
Roco�neatioa ar new circuit for tFu r�eplscear�nt of other penr»nmtay wi�
applianaas/fixt�.
New circuit for the$ddition ofA/C to an�„�d��1.�,�1i�$��l����
iAd�vidual ey�tet�.in a duplax or ooado��j,ino��diag required service
eleotric�! oudexs.
Odur
The value of thi�work ie$ 2 0 0 . o�
I,hcroby verif�thi� wor�c will be performad by an lo
the.reco�a�ion/inst�l�ation will be done in oo�aplianoe wi�maau�ctureryaad Ele�ctricv��
re9�ure�qnents. cAda
cs, � � _ s-'� ��3
�Cur'°°f Co�P�Y Officer) � (Piittt N�oe of bf�icer)
(Dace}
a� ���� Jro�