HomeMy WebLinkAbout0156506-HVAC (a/c) � CITY OF OSHKOSH No �5ssos
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1103 E IRVING AVE Owner MERCY MEDICAL CENTER OSH INC Create Date 07/02/2013
Contractor BETTER HOME HEATING&AIR CONDII Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel Gas OiI (-✓ Electric �Solar j Solid �
System � New j � Replace � � Other �
Forced Air Radiant Steam d A/C 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\2.5 ton 13 SEER Trane AC unit
of Work �
L�
Fees: Valuation $2,700.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: L��� Date 07/02/2013
❑ Permit Voided I Parcel Id#1104430000 '
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
Fax (920)236-5084 O�HKO�H
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
If vou are a contractor participatin� in the Permit fee Account Svstem and have adeguate funds check here
if vou want this processed throueh your 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 EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE � - � � ���
JOB ADDRESS/ �`3 �
owivER /� � f;� _��ED� '
CONTRACTOR " �
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JUL 012013
CHECK�ALL APPLICABLE
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USE CATEGORY " �'�"�-opHE�rr
fv�,s��;_..r�<. .._x�•ic,e �� ta
CC�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial �nc�us'�rial
FUEL ❑Gas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
C3�`orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
IS CHIlVIlVEY 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 �
DESCRIPTION/SCOPE OF ALL W RK BEING DONE (�i�
�
VALUE(Including labor and materials) $ � ��Z- U 6
ELECTRICAL CONTRACTOR(for projects not requiring an EN Form) �
� � ��7� o�/o�