HomeMy WebLinkAbout0104148 HOSHKOSH
ON THE WATER
.lob Address 320 KNAPP ST
Contractor MARX MECHANICAL
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner ANTHONY/OPAL PANSKE SR
Category 500- Residential-Heating & Ventilating
L~ Electric
New ] ~] Replace ]
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~) Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~] As Per Plan ~] Variable ~ Other I Value
No
Create Date
Plan
~ Solid
104148
09/12/2003
Other ]
Vent
Use/Nature SFR/Replace boiler. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,430.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$42.50
Date 09/12/2003
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
Agent/Owner
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 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 Ost~osh
Division of Inspection Services
P.O. Box 1130
Oskkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
g ' p o ided.
Incomplete applicafio~ will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box l 128,
Oshkosh WI 54903-I 128. Commencing work without perrier(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a co~tractor participatin~ in the Permit fee Account System and have adequate funds, check here
if you waist this processed ~hrough your account [~
JOB OD=SS 3¢ 0
OW=R
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
',~ingte Family IqDuplex 12Multi-Family
[2P, ental
[2Commercial
Ulindustrial
FUEL ~[tGas 12tElectric [2]Solid
E]Oil []Solar
SYSTEM
[]]New
[] Other
~:~Reptace
E]Fo~, ed Air []Radiant 12]Steam []A/C ~Vent [2Electric
IS CItIkVINE¥ BEING LI'N~ED ~lNo []Yes - LiN'ER SIZE
Note: Ail chinmeys s ~alI be sized per the BTU's being vented.
~Hot water IqSuppl.
& MANUFACTURER
Burner
CItlMrNEY TYPE
Il]EAT LOSS
BTU RATE
[21ChinmeyA
E]AsApproved
l-lAs PerPlan
[21Chinmey B
DExisting
ElVariable
[]Direct Vent
[]Not Applicable
[]Other Value
DESCRIPTION OF ALL WOILK BEING DONE
ElOther
VALUE (Including labor and all materials including light fixtures) $ ¢~ q~)0 ?'~
ELECTRIC= CONTRACTOa q:-L
U For applicable projects, an Electric Installation Veri~cation form, sigmed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Elect~ScaI Permit is required.
~, 0~/10/200~ lg:0~ g2023172SS ~EEZ ~ FCTRIC P~GE ~l
Electric Installation Verification
(I) (We) B. eez Elecffic. Ina.,
5:21 W. 12th. Oshkosh WI 54902
have been contracted to perform electde installation work for ~,
at the following addreas; 320J~ao~)
The nature of thc work consists of: (Check One or Describe the Nature of Work)
R~onneetion or n~v drcuit for replacement ~af~ Pla~ ~or MC Condms~.
Remme~i~ or new dmit for ~h~e~ El~tdc Wat~ H~r.
Rem~im of~e Se~m Enmce C~le, M~ Box, ~t~ion~ to r~t~l~
li~g fimwes due to sing / soffit insffilaflon. Note: New S~ ~tmm ~les
~li ~q~ a ~ pemk.
~ Rec~e~m or mw drm~ for o~er
The velue of this work is $150.00
I hereby ,~d.fy tht, work will be performed by an employee ofthls company and further verify the
re~ormection / installation will be done in compliance with manufacturer smd Elecffic code
requirements.
(Signature of Company Officer)
.Om'Y Biesingcr 09/10/03