HomeMy WebLinkAbout157117 HVAC (replace furnace) � CITY OF OSHKOSH No 757117
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 104 E CUSTER AVE Owner LANCE A/SHELLY K RHODE Create Date 08/08/2013
Contractor BETTER HOME HEATING&AIR CONDII Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate _
Fuel ✓ Gas � �Oil Electric �olar � �Solid
System New � Q Replace___ i ❑ Other �
✓ Forced Air �Radiant _ Steam QA/C � �nt
Electri� �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 As Per Plan _ � Variable � Other _ Value
Use/Nature SFR/replace fumace
of Work
��'ck#72042"
i
Fees: Valuation $4,350.00 Plan Approval $0.00 Permit Fee Paid $94.00
----------- — —
Issued By: Date 08/08/2013
❑ Permit Voided ' Parcel Id#1505240000
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 1054 AMERICAN DR NEENAH WI 54956 -1305 Telephone Number 920-733-2161
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
Fax (920)236-5084 O�KO�H
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 54903-1128. 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 partici�ating in the Permit fee Account Svsterit and have adequate funds, check here
if vou want this processed throuQh vour account ❑
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Horneowner(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 returned for cornpletion.
DATE �--� �7 ��'-3
JOB ADDRESS_,7` � �-�C-z.c-�9 / �
� �6
OWNER . RE IV]E�
CONTRACTOR
AUG 0 8 2013
CHECK Q ALL APPLICABLE
USE CATEGORY " ` "'.' ;
cos� a-r;����
d8�ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial�vsrEC��,�1}�����U1�'}giOti
FUEL C�'Gas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
TY�E
Q�orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
IS CHIlVINEY BEING LINED ONo ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIlVINEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCItIPTION/SCOPE OF ALL WORK BETNG DONE �Q.G�`� ��
VALUE(Including labor and materials) $ `7 �� �`v�
�
,
ELECTRICAL CONTRACTOR(for projects not requiring an EN Form) �
�� �� — r���/ � o�/o�