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Home My WebLink About0156746-HVAC (mini split) � CITY OF OSHKOSH No 156746 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 421 STANLEY AVE _ Owner MR/MRS JEFFREY J TYRIVER Create Date 07/17/2013 Contractor BETTER HOME HEATING&AIR CONDII Category 501 -Residential-Air Conditioning Plan Inspector John Zarate Fuel Gas I Oil ✓ Electric� Solar Solid System �✓ New � � Replace I Other � J Forced Air i Radiant Steam ✓ A/C Vent � Electric ll Hot Water Suppl.—� Con.Burner Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable Heat Loss As Approved � Existing � Not Applicable Value BTU Rate As Per Plan � Variable � Other � Value Use/Nature SFR\Installing Mitsubishi Mini split of Work I � I � i I � _ Fees: Valuation $5,600.00 Plan Approval $0.00 Permit Fee Paid $110.00 Issued By: Date 07/17/2013 ❑ Permit Voided I Parcel Id#1209130000 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 pertormed 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 � Fa�c (920)236-5084 JI--I ON THE WATER HVAC PERMIT APPLICATION JUL 171013 All information after bold categories must be provided. , Incomplete applications will not be processed. neP,�xTate�r oF ' Co�1�tU\ITY pEVELOP'1fEVT • Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection�e vices,��ox�Q�28, 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 IJvou are a contractor participatin� in the Permit f'ee Account Svstem and have adeguate funds. check here if vou want this processed through vour 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 horneowner)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 �`S^� JOB ADDRESS OWNER CONTRACTOR $ �/�� CHECK�ALL APPLICABLE USE CATEGORY C�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial : FUEL Q'Gas ❑Electric ❑Solid SYSTEM ONew ❑Replace ❑Oil ❑Solar ❑Other TYPE ❑Forced Air ❑Radiant ❑Steam Q�/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner IS CI�IlVIlVEY 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 WORK BEING DONE �r t.c. !�'a � VALLTE(Including labor and materials) $ � � ��`d� ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) � : � o� � ��'Q� o�/o� Jul 16 2013 7: 04RM HP LRSERJET FRXTRUMPHELE 9z07343838 page 2 , r`~..ry-�...�,,,�,,,w �.."�,,,•,�..�..�,..--.�....,,,�, � " """'^.,,,..�....,_._,. CkY et WbkaA `^�"'"""`��`�""n � Divi�io�olltip�cooa 8ervkes 21 S Glwrop Avenue HO ieY t�10 �Uko�4 WI 5490l.I 130 01hoe 9�0.176�SO30 Pon Y20-�.96-SOtI ' Electric In:tallation V'er�fication t �w�� - (Electricai Contractar ld�me) S�'�/9/i (Addres�) itY) ; (State) (ZiP Code) heve bep�contracted to perforw electric installatio�,wark for � �, ere,�w�e (Name of party cor�cted to) � at the fo]lowiqg�ddreee: � �) s q , (Addresg where worl¢will bo perfoaned) The nature of the work con�iats of (Check One or Dcscrilie the Nature of Work} Reconne�etion or aew circuit fvr replacc�anont�Ieatiug plan,t eind/or A/C Condene�r. Recvanoedon or naw clrcuit for repladran�rrt�iectric'Wat�r Heater or power veated water hmater. F.econneetion of the Service 8rltrance�able,I�ieter$ax, a]terationa to reccptacles aad lighting fix�uros dtto to�iding/�o�"tt�stalls�a�. Note: New Service F.�atranca Cables will requi�a a�eparate par�ru� _,,. Reconaeation or new circuit far the repl�ceme�.t of othor permanently wired applianoes/fixtur+cB. � �, New circuit for the ad.�ition of A/C to an indivlduu!dwe!l�ng unit(bouee or the individual �yste�ns in a duplax or oondomi�,ium),inc�uding required service electrica] o�advts. Other � The value of this work is $ �00.00 I her�by verrify tla�ia work will be performod by sa dnployae of this comppx�y and fi�rt(ier verifj, the raonnectian J install�tion wiq b�doae in s;nmpliaace with manufaaturer�d Electric code requirernents. . � / � 7r 1�..�� . � Signaturc of Company Off cer) (Frint Name of O�cer) (D�te) : sro2 '