HomeMy WebLinkAbout0158336-HVAC (boiler) /�'� CITY OF OSHKOSH No 158336
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1260 ELMWOOD AVE Owner BIRCHWOOD APARTMENTS LLC Create Date 10/18/2013
Contractor HOMETOWN HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas Oil _� Electric � Solar ' Solid
i
System � New I � Replace � Other j
Forced Air ✓ Radiant �Stea� A/C I Vent
Electric ; ✓ Hot Water Suppl. _� Con. Burner ,
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 0 Variable � Other _� Value
Use/Nature MFR\Replacing boiler
of Work �I� I
� �
i
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Fees: Valuation $8,000.00 Plan Approval $0.00 Permit Fee Paid $142.00
Issued By: �� Date 10/18/2013
❑ Permit Voided I Parcel Id#1204710000
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 essary vals before starting such activity.
Signature � �--__----�"'y�_ Date Q � �3
AgenUOwner
Address 5518 REIGHMOOR RD OMRO WI 54963 -9439 Telephone Number 920-379-9940
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 OlHKOlH
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 you are a contractor participating in the Permit fee Account Svstem and have adeguate funds, check here
�vou want this processed throu�voz�r account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Con�actor 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 I��''^I�
JOB ADDRESS�Z�� ��/'?u.s'���
OWNER SA��(.1 l,lf I �L�`�'
CONTRACTOR����v�_�����l,t.,
CHECK�ALL APPLICABLE
USE CATEGORY
❑Single Family �Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �Gas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
❑Forced Air �C2adiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
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��_,�C o��.C�C
VALUE(Including labor and materials) $ ���.�
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)��Q �
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