HomeMy WebLinkAbout0157989-HVAC � CITY OF OSHKOSH No 157989
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 904 MOUNT VERNON ST Owner RYAN D ANDERSON Create Date 09/10/2013
Contractor ANDERSON HVAC LLC Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel � Gas Oil Electric___j Solar � Solid
System ❑ New � � Replace I � Other �
Forced Air i Radiant Steam� A/C � Vent
Electric Hot Water Suppl. Con. Burner I,
Chimney Type Chimney A � Chimney B 0 Direct Vent � Not Applicable
Heat Loss As Approved 0 Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature CONVERSION TO SF/LATE PERMIT/New furnace and ductwork. i
of Work
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Fees: Valuation $4,400.00 Plan Approval $0.00 Permit Fee Paid $194.00
Issued By: ,, •�._ Date 09/30/2013
❑ Permit Voided ; Parcel Id#1002410000
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)an to sec an necessary a rovals before starting such activity.
Signature �� Date
AgenUOwner
Address 2070 ABRAHAM LANE OSHKOSH WI 54904 -7733 Telephone Number 920-230-6963
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
Fa� (920)236-5084 Of HK01H
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$100.00 plus the
normal permit fee,which ever is greater.
OR
1}'vou are a contractor narticipating in the Permit fee Account Svstem and have adeguate funds check here �
if vou want this Drocessed throu�h vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form,signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications submitted without an EIV when such is required, will not be :
processed for Permit Issnance and will be returned for completion.
DATE ��0 �/�
JOB ADDRESS � � 1 %��! / U�/ ��y-1
OWNER Y O� �" �t� rX P��� �
CONTRACTOR �(',��o r'SAyJ � V � �
CHECK�ALL APPLICABLE
U E CATEGORY
Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �ras ❑Electric ❑Solid SYSTEM �New ❑Replace
�70i1 ❑Solar ❑Other
TYPE
�orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
i
IS CHIMNEY BEING LINED �No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B �Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ��P�N'l j � � ���� D�,J J�JC/ ���y/�
/�U ; � S 77J �Lr G-� GJ��ir fic� /���1� �/��,'S �o/]�.�L,v �/� cf
VALUE(Including labor and materials)$
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o�/o�