HomeMy WebLinkAbout0157548-HVAC (a/c) /�'� CITY OF OSHKOSH No 157548
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1902 HAZEL ST _ Owner DONNA M ZMOLEK SURVIVORS TRUST Create Date 09/04/2013
Contractor DRUCKS PLUMBING&HEATING CO IN( Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel Gas Oil i Electric Solar � � Solid __�
System ❑ New I � Replace I Other �
Forced Air Radiant Steam ✓ A/C ��i Ven�
Electric Hot Water Suppl. I Con. Burner j
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
"*debit acct'*
` ---- — -- _
Fees: Valuation $2,800.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: '�'1ti� Date 09/04/2013
❑ Permit Voided j Parcel Id#1514816600
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 314 APPLETON 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 1130 �
Oshkosh;Wl 54903-1130
Phone(920)236-SO50
Fax (920)236-5084 �
ON'4F\YATFR .
HVAC PERMIT APPLICATION
Ati information after bold categories must be provided.
Incomplete applicatians 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$100.00 plus the
norroal permit fee,which ever is greater.
OR _
r c o r P mit e coun e n have a e heck here
w t r o r un
**Advisory-For applicable projects, an Elec�rical Installation Verification(Ell�form,signed by the Electrica!
Contractor or Homeowner(for installations allowed to be perfoimed by the homeowner)must be snbmitted
witi�the pe=mit application. Applications snbmitted withont an EIV when such is raqnired,will not be :
pmccssed for Permit Issaance and will be retarned for completion.
� DATE 5 ' �f-i 3
�OB ADDRESS �y 0� ha z c i st �
OWNER,Aanna Z�,o/r k
CONTRACTOR J��''+�kS f
1
CHECK�ALL APPLICABLE
USE CAT�GORY
�Single Ftimily ❑Duplex ❑Multi-Family ❑Rental ,�Commercial Olndustrial
FUEL OGas ❑Electric ❑Solid SYSTEM - DNew L$Replace
OOiI ❑Solar ❑Other '
TYPE � :
❑Eorced Air ❑ltadiant ❑Steam �A/C ❑Vent '�Electric ❑Hot Water ❑Suppl. OCon. Burner
IS CHIMNEY BEING LINED ONo❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shul)be sized per the BTU's being vented.
CHIMNEY TYPE DChimncy A OChimney B ❑Direct Vent ❑Other :
HEAT LOSS OAs Approved OExisting ONot Applicable
BTU RATE ❑As Per Plan ❑Variabte OOther Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE�e p4 ee � e.x.Yf�'.s A�:
c o n d�'l�:n�'n a.
VALUE(Including Isbor and materials)$�� p �O.O n
ELECTRICAL CONTRACTOR(fur projects nut requiring aa EIV Form)
o�/o�
ti'd b80S9�Z�Ol �S90-ZZZC 0z6) JNIBWfI�d S�I�fl�10�W0�1� Hbti�60 �IOZ-b-d