HomeMy WebLinkAbout0156510-HVAC (furnace & a/c) � CITY OF OSHKOSH No 156510
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2420 PARKSIDE DR Owner MARK A LEAFGREN/JENIFER M JENSEN Create Date 07/02/2013
Contractor MARX MECHANICAL _ Category 502-Residential-Both Plan
Inspector John Zarate
Fuel ✓ Gas j Oil ✓ Electric � Solar I Solid
System � New � �✓ Replace � Other
✓ Forced Air Radiant Steam ✓ A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A � Chimney B 0 Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate � As Per Plan � Variable � Other � Value
Use/Nature Repalce AC and furnace
of Work '
�
�
Fees: Valuation _ $6,200.00 Plan Approval $0.00 Permit Fee Paid $126.00 '
Issued By: �_,P Date 07/02/2013
� Permit Voided I Parcel Id#1227020000
In the perFormance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920-235-6510
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
12� `'
Ciry of Oshkosh
Division of Inspection Services �
P.O. Box l 130 �
Oshkosh,W] 54903-1]30
Phone{920)23G-SOSO �
Faa (920j236-5084 ����
C�'�.T H F\':'P,T f-F
HVAC PERMIT APPLICATION
All infom�ation after bold categories musi be provided.
Incomplete applications will not be processed.
• Applicaiion(s)and fee(s)can be brought to City Hall, Room 205 or mailed to lnspeciion Services, PO Box 1]28,
Oshkosh W1 54903-i 128. Commencing work without permit(s) will result in fees being doubled or$]00.00 plus the
normal pennit fee,which ever is greaier.
OR
/1�vou are u contrac�or pu�•ticipalin� in the Perrni�fee Accour�i Svs7em G11L� I7GVC adequale funds, check herc
if vou i��ant this processed ihrough vour account � �
**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 Issnance and will be returned for completion.
DATE L(-' �"� I�
JOB ADDRESS ��I i3� ��� l�. S l �L 1.� ✓�..
R�CEIVED
OWN�R I�'l P�'Z l�-t .��►i i-t�rL �.��r C-�- ��
CONTRACTOR Narx �;echanical, Inc JUN 2 8 �013
CH�CK 0 ALL APPLICABLE ll£PARTAIE\T OF
CO�i�i���7'�lr'!?EVELOP.ME:VT
IVSP£� I"ei;•:�SER�'ICES DI�'iSIQ�V
USE CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �JGas ❑Electric �Solid SYSTEM �New '�eplace
❑Oi] ❑Solar ❑Other
TYPE
'�'orced l�ir ❑Ra��iant ❑Steam �i1;C ❑Vent ❑Tlectric OHot Waier ❑Suppl. ❑Con. Burner �
lS CNIMN�Y BrING 1,IN�D �No�'Yes - LINER S1ZE 3N &MANUFACTUR�R_ r1 rK �-
Note:All chin�neys sliall be sized per fhe BTU's being ventcd.
CHIMN�Y TYPE ❑C11i►nney A ❑Chimney B R�Direct Vent L1Uther
HGAT LOSS ❑As Appr�ved f�Lxistinb ❑Noi Applicable
13TU RATL' ❑As Per Plan ❑Variable �'Oti�er Value � ����� _ :
llES RIPTION /SCOP� OF ALL WORK BLING DONr_
I��P�k ����R-,•►r��s �- f! I C� _
� I ,, �J
VALU�(Including labor and materials)$ W�-
�L�CTRICAL CONTRACTOR(for projects�iot requiring an EIV Form) �
o�/o�