HomeMy WebLinkAbout0156788-HVAC (a/c) � CITY OF OSHKOSH No 156788 `
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1245 GREENFIELD TRL Owner VALERIE A KLIKA Create Date 07/19/2013
Contractor MARX MECHANICAL __ Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
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Fuei Gas j Oil ✓ Electric � Solar �' Solid
v
System ❑ New I � Replace � Other '
Forced Air Radiant Steam ✓ A/C �' Vent
Electric ' Hot Water Suppl.� Con.Burner I
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan 0 Variable � Other Value
Use/Nature SFR/replace A/C
of Work ; '
*'ck#10526"'
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Fees: Valuation $2,520.00 Plan Approval $0.00 Pertnit Fee Paid $62.00
Issued By: `�1,_ Date 07/19/2013
❑ Permit Voided I Parcel Id#1313640000 �
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In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. `
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920-235-6510
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To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone �
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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City of Oshkosh
Division of Inspection Services �
P.O.Box 1 l30 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 ��H
ON TNF WATFR
HVAC PERMIT APPLICATION
Ail information after bold categories must be provided.
lncomplete applications wil) not be processed.
• Application(s)and fee(s)can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$]00.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participating in ihe Permit fee Account Svslem and have adequate funds, check here
if vou want this processed through vour account n
**Advisory-For applicable projects, an Elec�ical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations�allowed to be performed by the homeowner)mnst be snbmitted
with the permit application. Applications submitted without an EIV when snch is reqnired,will not be
processed for Permit Issnance and will be returned for completion.
DATE i'� � ���
JOBADDRESS Io��� ���N�IC�LI� ��I�-
OWNER VI��-«� ��I►� a RECE�VED
CONTRACTOR �arx Nechanical, Inc JUL 18 2013
CHECK 0 ALL APPLICABLE UEP:1RTitF?:7;�?�=
C0�1�tU\iT2'DE�"ELOP�IEVT
USE CATEGORY INSPECTiON SER�'10ES DI�'iS10V
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas ($�lectric ❑Solid SYSTEM ❑New f�Replace
❑Oil �Solar ❑Other
TYPE `
E
❑Forced Air ❑Radiant ❑Steam [�"A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner ;
f
IS CHIMNEY BEING LINED�'I�Io �Yes -LINER SIZE &MANUFACTURER �
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Cliimney A ❑Chimney B ❑Direct Vent I�Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
�ESCRIPTION /SCOPE OF ALL WORK BEING DONC__����� � 'C� VV_I�t _
��� �� i� (�I��- ��3�� �-��a- �� --
VALUE(Including labor and materials)$ ���� W
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
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