HomeMy WebLinkAbout0156672-HVAC (mini split system) � CITY OF OSHKOSH No 156672
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1104 N MAIN ST Owner WALTER GEHRKE Create Date 07/12/2013
Contractor A&BE HEATING AND COOLING Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel Gas Oil ✓ Electric Solar � Solid
System � New � � Replace ! Q Other �
Forced Air � Radiant Steam ✓ 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/install mini split system for upstairs
of Work
Fees: Valuation _ $1,100.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: t �-..� Date 07/12/2013
❑ Permit Voided I Parcel Id#1001530000
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 s ny necessary approvals before starting such activity.
Signature � �/�--J Date ���G���./
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 Buiiding 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 Osl�kosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fa� (920)236-5084 Of HKOlH
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$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participating i» the Permit fee Account Svstem and have adeguate funds, check here
if vou want this processed through voz�r account n
**Advisory-For applicable projects, an Electrical Installadon Verification(EI�form, signed by the Electricai
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted without an EIV when such is reqnired, will not be
processed for Permit Issnance and will be retarned for completion.
DATE �'�����
JOB ADDRESS � ` /1�� /!/ � �4�%-i j��
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OWNER ► Y L G/�I�v�� "� �Gc I�C/ �Q 1�P �e
CONTRACTOR I�'4- � I-^ /lec'�:�•f ��•� �oo/iG
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CHECK B(ALL APPLICABLE
USE CATEGORY
�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �as ❑Electric ❑Solid SYSTEM �Iew ❑Replace
Oil ❑Solar �DOther
TYPE
❑Forced Air ❑Radiant ❑Steam �A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
l-
IS CHIMNEY BEING LINED �o ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per he BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing �Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
l
DESCRIPTION/ COPE OF ALL WORK BEING D NE Il � �� 11CG�
�` ,` � � � ��
VALUE(Including labor and materials)$ , ��1(/
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) i i
o�/o�