HomeMy WebLinkAbout0158516-HVAC (furance) � CITY OF OSHKOSH No 158516
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 713 W 8TH AVE Owner MARK A MARIN Create Date 10/29/2013
Contractor BLACK-HAAK HEATING Category 500-Residential-Heating 8 Ventilating Plan
Inspector John Zarate
Fuel �/ Gas Oil Electric � Solar � Solid '
System � New �i 0✓ Replace ' Q Other i
✓ Forced Air Radiant Steam _ �A/C Vent
Electric Hot Water Suppl.__ _� Con.Burner
Chimne T e Chimne A �
Y YP � y _� Chimney B � Direct Vent � Not Applicable I
Heat Loss As Approved � Existing � Not Applicable i Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature 'SFR/replace furnace
of Work !
'"ck#5753""
I
----
—
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $46.00
Issued By: _�L(/`� Date 10l29/2013
❑ Permit Voided , Parcel Id#0601380000
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.
City of Oshkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1 1 30
Phone(920)236-5050
Fax (920)236-5084 O HKO H
ON THF'J✓ATFR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Iucocnplete applications will not bc proccssed.
• 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 throu�vour account n
**Advisory-For applicable projects, an Electrical Installarion 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 submitted without an EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE I G ' oi S-13
JOB ADDRESS �I I 3 l,[� �7��'l� }�(l'�.� ���.�����
OWNER I�YIa,�k mGI.Y 1►1 :
CONTRACTOR��G�C,�C - }�ct�.k N ec�-i►�7,, '�.�c � 0 C T 2 8 2013
CHECK�ALL APPLICABLE �;;�,-���;,���;r;,F
co�i�i�:,.rT,-��d��a.aP:���vr
UST+�ATEGORY ��sP�c�r���:��.,�,a,,,�rs pn�is�ov
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �as ❑Electric ❑Solid SYSTEM ❑New l�Keplace
❑Oil ❑Solar ❑Other
TYPE
f�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED �IONo ❑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 ONot Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
�►c�n-hr�l rn�cc�� YP� 1uC��'l�nt
VALUE (Including labor and materials)� OGb��
�•
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) fl J�//rl �U� � ��� �4 �
a�/o�
J�err��-t F�� � '� �f-� `�
� �
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 THF 'd✓,hTfR �
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be pmvided.
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 ar$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds check here
�you want this processed throuQh vour account ❑
DATE f0 - �5- /3
JOBADDRESS 7i3 � �r�Ij'1�Y� �U�
OWNER_ 11�GE-V� I f��.l�l i�
CONTRACTOR PJI�tL'l�- Nact k I-I�' -I�()U �i'1C
CHECK �ALL APPLICABLE
USE CATEGORY
CdSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE �Overhead C�7I�tot Applicable
❑Change C�91 T�Ot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles# Circuits#
Phase
Amps Switches# Fixtures#
CHECK 0 ALL APPLICABLE
❑Range ❑D' hwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower �urnace ❑A/C ❑Electric Sign
❑Motars ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE I.V I�'Q -�(�!nu�Q �Q�jIG(CQ�('Y1;F.1`2"F-
VALUE (Including labor and all materials including light fiatures)$ �
MASTER ELECTRICIAN �}I V i+� u 5('.�� � �3I U8�o
,�j �^J�/ 3/02
��i���'�' / -e� ' ",f �/ �.