HomeMy WebLinkAbout0157159-HVAC (furnace & a/c) €
� CITY OF OSHKOSH No 157159
. OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 14 STONEY BEACH RD _ Owner JAMES A/JEANETTE M ROBINSON Create Date OS/12/2013
Contractor A 8�BE HEATING AND COOLING Category 500-Residential-Heating&Ventilating Plan i
Inspector Nicole Krahn
�
Fuel ✓ Gas Oii Electric I Solar Solid
System � New � �✓ Replace � �] Other �
✓ Forced Air Radiant Steam A/C � Vent
Electric Hot Water
� Suppl. j Con. Burner
Chimney Type Chimney A � Chimney B 0 Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable � Value
BTU Rate As Per Plan 0 Variable � Other Value
Use/Nature SFR/replacing furnace and A/C units
of Work
I
Fees: Valuation $4,800.00 Plan Approv $0.00 Permit Fee Paid $94.00
Issued By: -J'�a � Date 08/12/2013
❑ Permit Voided � Parcel Id#1414600000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the Ciry 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 secu y nece�appr als before starting such activity.
Signature �j���—��
Date ��
AgenUOwner
Address 1303 MIDWAY RD MENASHA WI 54952 -1129 Telephone Number 920-268-4966
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� (920)236-5084 O1HKOfH
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
If vou are a contractor �articipatinQ in the Permit fee Account Svstem and have adeauate funds check here
�vou want thts Drocessed through vour 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)mnst be snbmitted
with the permit application. Applications snbmitted without an EIV when such is required, will not be
processed for Permit Issnance and will be returned for completion.
DATE ���' �
JOB ADDRESS /L ����` C�G1�'`'�
� , -
OWNER �-^t v� d 'r� a
CONTRACTOR y eG�1`.:1 -�1� �Gt>��
�
CHECK Bf ALL APPLICABLE
USE CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL (�as ❑Electric ❑Solid SYSTEM ❑New �Replace
❑Oil ❑Solar ❑Other
TYPE
/�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
1
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 �Direct Vent ❑Other
HEAT LOSS ❑As Approved xisting ❑Not Applicable
BTU RATE ❑As Per Plan �ariable ❑Other Value
DESC PTION/SCOPE OF ALL WORK BEING DONE �Q�I�tl� /wi1lJGP
�� /�-/�'
VALUE(Including labor and materials)�/T���
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ��1� �� > ' �'�,���"`
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