HomeMy WebLinkAbout0156886-HVAC (boiler & pump replacement) � CITY OF OSHKOSH No �sssss
OSHKOSH HVAC PERMIT -APPUCATION AND RECORD
ON THE WATER
Job Address 315 ALGOMA BLVD Owner WIS BELL INC _ Create Date 07/19/2013
Contractor MECHANICAL TECHNOLOGIES Category 510-Ind.&Comm-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas � Oil _� Electric _ Q Solar I Solid I
System New � �✓ Replace ' � Other _�
Forced Air Radiant � Steam A/C I Vent
Electric Hot Water Suppl. Con. Burner ;
Chimney Type Chimney A 0 Chimney B � Direct Vent � Not Applicable �
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other ��, Value
Use/Nature COMM/boiler and pump replacement
of Work
"ck#55771** I
'ck#55791" _
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Fees: Valuation $139,945.00 Plan Approval $0.00 Permit Fee Paid $904.00
Issued By: ��,`, Date 07/25/2013
❑ Permit Voided I Parcel Id#0101220000
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 pertorm 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 PO BOX 12176 __ GREEN BAY WI 54307 -2176 Telephone Number 920-491-5860
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 l 130
Oshkosh,WI 54903-1130 �
Phone(920)236-5050
Fax (920)236-5084 Q�HK��
O?=' TF�f i:'ATFF -
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-I 128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee, which ever is greater.
OR
I/'vou are a contractor DarticinatinQ in ihe Permit fee Account Svstem arrd have adeq:rate funds check here
tf vou want thrs Drocessed throuQh vot�r 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 homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed-for Permit-Issuance and will be retnrned for completion. -- ---- ----
DATE ���`���'�'�:','"_`' �
JOB ADDRESS �%�,�! %���-'� ;� . ::�
_. .- RECEIVED
OWNER ;��%`
CONTRACTORi - <� �_�; i -� �' � JUL 19 2013
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CHECK 0 ALL APPLICABLE DEPARTIIE�T OF
C0�1�tU�iTY DEVELOP1fEVT
INSPEC'f10�SERVICES D1�7510V
USE CATEGORY
❑Single Family ❑Duplex ❑Multi-Family ❑Rental �Commercial ❑Industrial
FUEL �E'ras ❑Electric �Solid SYSTEM �New `f��eplace
'�Oil ❑Solar ❑Other
TYPE
OForced Air ❑Radiant ❑Steam ❑A/C �Vent OElectric ,C�Hot Water ❑Suppl. �Con. Burner
IS CHIMNEY 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 IIlDirect Vent ❑Other
HEAT LOSS �As Approved ,�J�xisting ��Not Applicable
BTU RATE ❑As Per Plan p�ariable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE � c?'�-��` �` ,� �� ,, ;.', ,�"; �' ,;.1 ,,. "`
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VALUE (lncluding labor and materials) $ f � ? �' ? ` -. • �'' °
.� ��- ��
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ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) �c;�•.J `.—,E i
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