HomeMy WebLinkAbout0157319-HVAC (a/c) � CITY OF OSHKOSH wo 157319
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2745 F HAVENWOOD DR Owner LELAND L/MARILYN J BURLISON REV TRi Create Date 08/20/2013
Contractor DRUCKS PLUMBING&HEATING CO INC Category 501 -Residential-Air Conditioning Plan
Inspector Nicole Krahn
Fuel ✓ Gas Oil Electric � Solar i Solid
System � New � �✓ Replace I � Other '
Forced Air Radiant Steam ✓ A/C Vent
Electric Hot Water Suppl. Con. Burner �
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
HeatLoss AsApproved � Existing � NotApplicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature ONDO/REPLACE EXISTING A/C UNIT "debit acct
of Work
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Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $78.00 '
Issued By: �� Date 08/20/2013
❑ Permit Voided I Parcel Id#1632024000
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 314APPLETON 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, 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.
City of Oshkosh •
Division of Inspection Services ' � ' �
P.O. Box I 130 �
Oshkosh;W[54903-1130
Phone(920)236-5050
Fax (920)236-5084 �--I
ON TVF 1YATFR .
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 5100.00 plus the
normal permit fee,which ever is greater. ,
OR _
lf vou are a conrroctor par�icinating in �he Permlt tee Accounf Svs[em and have adeouate tunds. check here
(f vou want �his vrocessed �hrough vour accoua� (�
**Advisory-For applicable projects, an Electrical Installation VeriFcation(EI�form,sigaed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)most be sabmiaed
with the permit appllcacion. Applications snbmitted wlt�tont an EIV when snch is reqnired,will aot be
processed for Pem�it Issnance aad will be retnrned for completion.
� DATE �'�o-/3
JOBADDRESSo� 7ys �'lavenwood ��;vc u��� .�
OWNER /�ar;ly/1 $yrli3on
CONTRa,CTOR U r Nc k S �
1
CHECK�ALL APPLICA.BLE
USE CATEGORY
�Single Family ❑Duplex OMulti-Pamily �Rental ,OCommercial ❑Industrial
FUEL �Gas ❑Electric ❑Solid SYSTEM - ❑New �Replace
❑Oil �Solar OOther '
TYPE
OForced Air ❑Radiant ❑Steam �A/C ❑Vent �Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CIiIM1YEY BEII�IG LIIVED�No DYes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTLJ's being vented.
CHIMNEY TYPE ❑Chimney A OChimney B ❑Direct Vent ❑Other
HEAT LOSS OAs Approved OExisting �Not AppJicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEINC DONE I�e ol�c� ex;J i��� y�[. �+n%t
VALUE(Including labor aod materfats)$3,.Soo.o0
ELECTRICAL COIVTEtACTOR(for proJects not requlring on EiV Form)
o�/o�
S'd b80S9�Z�Ol TS90-ZZLC 0Z6) JNIBWfI�d S�I�flzla�W0�1� dL0�S0 �TOZ-OZ-