HomeMy WebLinkAbout0156960-HVAC (furnace) r � CITY OF OSHKOSH No �sssso
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1123 N MAIN ST Owner WEST POINTE BANK Create Date 07/30/2013
Contractor HOMETOWN HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric-j Solar Solid
System � New � �✓ Replace ; � Other �
�
✓ Forced Air � Radiant Steam � A/C Vent
Electric 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 p As Per Plan 0 Variable � Other Value
Use/Nature SFR/Replace existing furnace. The existing b-vent will remain. Seckar electric will do the hookups.
of Work
i :
� I
' I
Fees: Valuation $2,800.00 Plan Approval $0.00 PermitFee Paid $62.00
Issued By: �9�,� Date 07/30/2013 .
❑ Permit Voided j Parcel Id#1007590000
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 ap rovals before starting such activity.
Signature Date �/,,
AgenUOwner
Address 5518 REIGHMOOR RD OMRO WI 54963 -9439 Telephone Number 920-379-9940
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,WI 54903-1130
Phone(920)236-5050
F� �9zo,z36_sog4 Of HKO.IH �
ON THE WATER �
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-ll28. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor ncarticinatinQ in the Permit fee Account Svstem and have adeauate funds check here �
tf vou want this processed thro�voa�r account I-1
**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 snbmitted
with the permit application. Applications snbmitted without an EIV when such is reqnired, will not be
processed for Permit Issnance and will be returned for compledon.
DATE ��'��^I 3
JOB ADDRESS�I�� /✓, ,�/�aM �f p��`
OWNER�i,S ./1 � ��,m�
CONTRACTOR�oYr+,G/a c,1,h, SI� �' eoo����
CHECK�ALL APPLICABLE
USE CATEGORY
�JSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL j�Gas ❑Electric ❑Solid SYSTEM ❑New �Replace
❑Oil ❑Solar ❑Other
TYPE
�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner :
IS CHIMNEY BEING LINED I�1o� -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�.e,rVby�. olp�I �✓,t�� 1 .p
d
cL ��► .[/.�„v wP.i�n4�
VALUE(Including labor and materials) $ �Q�C'
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) �pyr►� ��✓�r'
o�/o�