HomeMy WebLinkAbout0156622-HVAC (a/c) � CITY OF OSHKOSH No �5ss22
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1691 HUNTERS GLEN DR Owner DANIEL R/SARAH J PAULICK Create Date 07/08/2013
Contractor DRUCKS PLUMBING&HEATING CO IN( Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel Gas Oil Electric Solar Solid
System Q New I �✓ Replace I � Other �
✓ Forced Air Radiant Steam ✓ A/C Vent
Electric Hot Water Suppl. Con.Bumer
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable I
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature FR/replace A!C
of Work
debit acct"
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $78.00
Issued By: �� Date 07/10/2013
❑ Permit Voided I Parcel Id#1331850000
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 activiry.
Signature Date
AgenbOwner
Address 314 APPLETON ST MENASHA WI 54952 -2318 Telephone Number 920-426-2654
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Pertnit 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.
-6-2013 07:42A FROM:DRUCKS PLUMBING C920)722-0651 T0:2365084 P.1�1
City of Oshkosh •
Division of lnspection Services • . • �
P.O.Box 1130 �
Oshkosh;WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 H
ON 7MF\VATFR .
HVAC PERMIT APPLICATION
All information ofter 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 [nspection Services,PO Box 1128,
Oshkosh WI 54903-1128. Commen�ing work without permit(s)will result in fees being doubled or$100,00 plus tlie
normal permit fee,which ever is greater.
OR
o e !r r ' F he P rml� ee cco n a d av a uat
1 w r r o o r
**Advisory-Foz applicable pmjects, an Elcct�rical Installation Ve 'nfication(EI�form,signod by the Electrical
Contractor or Homeowner(for installations allowed to be perfotmed by the homeowner)amst be snbmitted
with the pernut application. AppGcations sabmitted withont an EIV when sach is reqnired, will not be :
processed for Permit Issaance aad w�l be retarned for comPletion.
� DATE T"� ��
�oB�D�ssl�� � �I����� � ,
OWNER � h � l`�C.
CONTRACTOR U�S 'S J����— �
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CHECK�ALL APPLICAIILE
USE C TEGORY
' gle Family ❑Duplex OMulti-Family �Rental .�Commercial ❑Industrial
FUEL � �Electric ❑Solid SYSTEM �New �Replace
CJOiI ❑Solar ❑Other '
TYPE � � ' .
�OForced A'v ORadiant ❑Steam �C/C ❑Vent OElectric OHot Water OSuppl. ❑Con.Burner
IS CHIIVVINEY BEING LINED(�No OYes -LINER SIZE &MANUFACTUREI�
Note:Akl chimneys shall be sized per lhe BTU's being vented.
CHIMNEY TYPE OChimney A ❑Chi.mney B ❑Direct Vent ❑Other
HEAT LOSS OAs Approved xisting ❑Not Applicable
BTU RATE ❑As Per Ptan ❑Variable ❑Other Value
DES ION/SC PE OF ALL ORK BEING DONE ��' �
S w.. {.��� NR.v o
VA1.UE(Including Isbor aad materials)$ �([7�'�
ELECTRICAL CONTRACTOR(for proJects not requirine xn EIV Form)
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