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Home My WebLink About2013-HVAC (a/c) /�"� CITY OF OSHKOSH No 157260 OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1789 RIVER MILL RD Owner MILES/ROBERTA S MAGUIRE Create Date 08/16/2013 Contractor BLACK-HAAK HEATING Category 501 -Residential-Air Conditioning Plan Inspector John Zarate Fuel Gas Oil � Electric j Solar_� Solid System � New � � Replace � � Other � Forced Air I 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 I Value BTU Rate As Per Plan 0 Variable � Other Value Use/Nature FR/replace A/C of Work �ck#5336�' I i Fees: Valuation $3,550.00 Plan Approval $0.00 Permit Fee Paid $78.00 Issued By: ��, Date 08/16/2013 ❑ Permit Voided I Parcei Id#1224400000 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 PO BOX 7075 APPLETON WI 54912 -7075 Telephone Number 920-757-9990 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. i City of Oshkosh Division of Inspection Services � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 Fax (920)236-5084 O HKO H ON TNF WATFR � 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$100.00 plus the normal permit fee,which ever is greater. OR If vou are a contractor narticinating in the Permit 1'ee Account System and have adeauate funds check here i('vou want this nrocessed through your account n **Advisory-For applicable projects, an Electrical Installation Verificadon(EI�form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. DATE g ad JOB ADDRESS17�S� �i ue.v �LI � 12ECEI�ED OWNER Ct Q,, CONTRACTOR ' Q �LI7C • AUG 16 2013 CHECK�ALL APPLICABLE DEP,�RTD7�\T OF C0�11tU:NI7'Y'DE�"ELOPb9E'VT USF�JEATEGORY INSPECTIOV SER�'ICES DI�'ISIOV (.rJSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial FUEL ❑Gas �Electric ❑Solid SYSTEM ❑New �lace ❑Oil ❑Solar ❑Other TYPE �� ❑Forced Air ❑Radiant ❑Steam �-0'A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED ❑No �LINER SIZE &MANUFACTURER Note:All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other HEAT LOSS OAs Approved ❑Existing ❑Not Applicable BTU RATE ❑As Per Plan ❑Variable ❑Other Value DESCRIPTION/SCOPE OF ALL WORK BEING DONE c v�a�1a��t : VALUE (Including labor and materials)$ 3 ,rJsb •� ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) �'��/�n �,[� �O/p��0 c� � o��o� �� 7�- . y City of Oshkosh Division of Inspection Services � P.O.Box 1130 � Oshkosh,WI 54903-1130 Phone(920)236-5050 �� Fax (920)236-5084 . ON THF WHTFR � ELECTRICAL 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 participating in the Permit Fee Account Svstem and have adequate funds check here if vou want this processed throuQh vour account ❑ DATE � �b I3 JOB ADDRESS I`1�� i ve v i �I (�G( OWNER ►'✓�V�T�( � (,L( CONTRACTOR ! - � Q(.l.`�7n C • CHECK a ALL APPLICABLE (�US CATEGORY ngle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial SERVICE ❑New ❑Temporary TYPE ❑Overhead ��ot Applicable ❑Change �.01�tot Applicable ❑Underground FII.L IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / Receptacles# Circuits# Phase Amps Switches# Fixtures# CHECK�ALL APPLICABLE : ❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater ❑Fan OR Blower ❑Furnace �C ❑Electric Sign ❑Motors ❑Gas Pumps ❑Other DESCRIPTION OF ALL WORK BEING DONE (,U/✓P �� VALUE (Including labor and all materials including light fiztures) $��• � MASTER ELECTRICIAN�L l Ul Vf �G(�S�' � /��0 5° � 3/02 P�C�i�/[�!�� G��• ��-