HomeMy WebLinkAbout0157925-HVAC � CITY OF OSHKOSH No 157925
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 825 GRACELAND DR Owner BAILEY J/ERIN J BRUEGGEN Create Date 07/16/2013
Contractor OWNER Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas � Oil Electric Solar Solid
System � New I � Replace � � Other �
Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. _] Con.Burner
Chimney Type Chimney A � Chimney B 0 Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable i Value
BTU Rate As Per Plan � Variable � Other � Value
Use/Nature 'SFR/Remodeling the basement to create a family room and bedroom. Adding ductwork for additional fishied living space
of Work �
�*ck#1094**
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: � Date 09/25/2013
� Permit Voided I Parcel Id#0617300000
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 se re any necessary approvals before starting such activity.
Signature - �� Date 9 , � /5
l AgenUOwner
Address 825 GRACELAND DR OSHKOSH WI 54904 -7962 Telephone Number :
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,WI54903-1130
Phone(920)236-5050
Fax (920)236-5084 01HKOlH
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
if tiou want this nrocessed 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)must be submitted
with the permit application. Applications snbmitted without an EN when such is reqnired, will not be
processed for Permit Issnance and will be returned for compledon.
DATE ��/��l�-�
JOB ADDRESS °��t�-,(_,�a ty I C�,✓�c� �J�r
^ :
OWNER—�1c„I?'v + E�;� �;ti�,��r�:�r��
CDNTRACTOR �c;•.il-�•j (1jr,.�.�,q��1-�"^
CHECK�ALL APPLICABLE
USE CATEGORY
`�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ❑Gas �lElectric ❑Solid SYSTEM �INew ❑Replace
❑Oil ❑Solar ❑Other
TYPE '
.�Forced Air ORadiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANLTFACTURER
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�s�d�✓�C%t r}uC.1 ln�C��(1� �C,�v-
��Y�A`4`'1L ��v;Yl!''; 5 iC�-('
VALUE(Including labor and materials) $ ;�,CJ C O
,
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ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ,���.��.�Lq ��u;,��q���1n
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