HomeMy WebLinkAbout0156684-HVAC � CITY OF OSHKOSH No 156684
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2455 SHORE PRESERVE DR Owner SCHMIDT BROTHERS CUSTOM HOMES II Create Date 05/03/2013
Contractor BRUSS HEATING&COOLING LLC Category 502-Residential-Both Plan .
inspector John Zarate
Fuel ✓ Gas Oil Electric Solar Solid �
System ❑✓ New � � Replace __� Other
�orced Air Radiant Steam ✓ A/C j Vent
Electric Hot Water Suppl. Con. Bumer !
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable �
Heat Loss As Approved � Existing � Not Applicable �i Value
BTU Rate As Per Plan � Variable � Other � Value
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Use/Nature iNSFR/INSTALL NEW HVAC SYSTEM FOR NEW HOME *'check#5253 '
of Work ' ��
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Fees: Valuation $6,995.00 Plan Approval $0.00 Permit Fee Paid $126.00
issued By: ���I�J Date 07/15/2013
❑ Permit Voided I Parcel Id#1281520000
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 W7626 MISTY SPRING CT GREENVILLE WI 54942 -8016 Telephone Number (920)740-2559
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.
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cit�of Oshl:osh -'°�.,�'_
Division of Ins-pection Services �
P_O.Box 1130 �
Oshkosh WI 5=�903-1130
Phone(92U)236-5050 --- �``'' —
Fax (920)236-5084 �_,�,� ,r���l_���
HVAC PERMIT APPLICATION
All infortnation after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s)and fee(s)can be brought to City Hall,Room 2U5 or mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1 1 28. 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 v�u are a contractor participatin� in the Permit fee Account Sti�stem and have adepuate funds, check here
if vou want this nrocessed throt�Qh vour account (�
**Advisory-For applicable projects, an Electricai Installation Yerification(EI�form, signed by the Electrical
Contractor or Homeowrrer(for instaIlations allowed to be perfornied 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 Issuance and wiII be returned for completion.
DATE 1 "" I ,� �
JOB ADDRESS 2'����+ ��V;,� � �� �, , !,� ,,� .
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OWNER �� � ''.
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CONTRACTOR��,�" `:��\ �`~�r 3�„��., (;,� , T '
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CHECK�ALL APPLICABLE
USE CATEGORY
l�Single Family ❑Duplex ❑Multi-Family �Rental ❑Commercial ❑Industrial
FUEL ...l�ias �Electric ❑Solid SYSTEM �New ❑Replace
DOiI ❑Solar ❑Other
TYPE
�'orcecl Air t7Radiant OSteam �A/C O�'ent QElectrlc �Hot Water �Sug�1. QC'on. Burner
IS CHIMNEY BEING LINED QNo QYes - LINER SIZE & MANtIFACTURER
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 DOther Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
VALUE(Including labor and materials) $ Y �r���
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ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
n�in�