HomeMy WebLinkAbout2013-HVAC /�"'+ CITY OF OSHKOSH No 156422
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 155 N SAWYER ST Owner SUBLUXATION PROPERTIES LLC Create Date 06/27/2013
Contractor A&BE HEATING AND COOLING Category 512-Ind.&Comm-Both Plan File-3800-0613
Inspector Nicole Krahn
Fuel ✓ Gas Oil Electric Solar ; Solid ,
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System a New � �✓ Replace � Other
✓ Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. Con. Burner I
Chimney Type Chimney A � Chimney B 0 Direct Vent � Not Applicable
Heat Loss As Approved � Existing � NotApplicable Value
BTU Rate � As Per Plan � Variable � Other i Value
Use/Nature OMM/Hvac for new chiropractic office' This additional fee to cover the changes in scope of work. Wor{c to include REPLACE(2) '
of Work FURNACES AND CHANGE SUPPLY AIR TO BUILDING ALSO REPLACED REGISTERS "check#1059
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Fees: Valuation $9,145.00 Plan Approval $0.00 Permit Fee Paid $174.00
Issued By: � Date O6/27/2013
� Permit Voided I Parcel Id#0608770100
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 1303 MIDWAY RD MENASHA WI 54952 -1129 Telephone Number 920-268-4966
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Jun. 27, 2013 8: 14AM MMC PCU1 Pod A No. 8643 P. 2
Ciry of Oshkosh
Division of Tnspecdon Services �
P.O.Box 1130 �
Oshkosh,WI54903-1 l30
Phone(920)236-5050
Fax (920)236-5084 IC�K�.I H
ON THE WATER �
HVAC PERMIT APPLICATION
All information af�er bold categories must be provided.
Incomplete applicacions will not be processed.
• .A.pplication(s)and fee(s)can bc brougbt to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,
Oshkosh Vl� 54903-1128. Commencing work without per►nit(s)wi11 resu(t in fees being doubled or$]00.00 plus the
nornaal peririnit fee,which ever is greater.
OR
!f vou are p conlrpGtor�,artic�a[ing in !he Permil fee Accounl SVSIem a►ad hpv�adeguQte Jvnds. chsck here
if vov wonl this nrocessed lhrough vour accounl n
**Adviso�ry-k'or applieab(e projeets, an Elech�cal Installation Verification(E�forni,sigued by the Electrical
Contractor or I�omeowner(for installatio�ns allowed to be�erformed by the homeow�ne�r)must be snbmitted
with the�ermit application. Applieatioxts sabmitted withont an EIV when sacb�zs Xequired,wi11 not be
pxocessed for Permit Issnance and will be retnYned for counnp�eaon.
DATE �� ` �
JOB ADDRESS �i� �� ��
OVVN��t is d �— � � - d �MC7:'
CONTRACTOR � �� �GrII��
CHECK�ALL APPLICAB�,E
USE CATEGORX
❑Single Family ❑Duplex ❑Multi-Family �Renta.l �Comnr�ercial ❑�zadustrial
FUEX. �C'ras ❑Electric ❑Solid SYSTEM ❑New �Replace
L70i1 ❑Solar ❑Other
TYPE
�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electtic ❑Hot Water ❑Suppl. ❑Con.Burner
YS CAIMNEY BEINC LINEA�No �Yes -LINER SIZE &MANUFACTURER,_,
Noce:All chimneys shall be sized p r the�BTiJ's being vented.
CT�YIVINEY TYPE ❑Chinnney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS l�As Approved ❑Existing �Not Applicable
BTU RATE L7As Per Plan ❑Variable ❑Other Value :
DESC�PT ON/SCOPE OF L WORK BEING DONE � � � �
u � � ` 'rt 4�'d
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VALUE(Iacluding Isbor and materials)$ r
�LECTRICAL CONTxtACTOR(for projects not requiring an ElV Form) e�1 t� Nl�+�P
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