HomeMy WebLinkAbout0158570-HVAC (furnace & a/c) €
� CITY OF OSHKOSH No 1ss5�o
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 906 GRAND ST Owner THOMAS E KOCH Create Date 11/01/2013
Contractor MARX MECHANICAL Category 502-Residential-Both Plan
Inspector John Zarate
Fuel ✓ Gas I ' Oil � [ Electric I Solar Solid
System Q New I Replace __ i � Other !
Forced Air Radiant Steam �C Vent
Electric Hot Water Suppl. Con.Burner I
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable i
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value 90,000 BTU input
Use/Nature Replace the Furnace and A/C I
of Work
"Paid by check '
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Fees: Valuation $6,400.00 Pla�Approval $0.00 Permit Fee Paid $126.00
Issued By: Date 11/01/2013
❑ Permit Voided 'I Parcel Id#1003840000
In the perFormance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number 920-235-6510
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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Ciry of Oshkosh ��
Division of Inspection Services � �
P.O.Box 1130 � �
Oshkosh,WI 54903-1130 e
Phone(920)236-5050 ;
Fax (920)23G-5084 �HK01H
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HVAC PERMIT APPLiCATION �
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Al] informaiion afier bold categories must be provided. ;
Incomplete applications wili noi be processed.
• Application(s)and fee(s)can be broughi to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, ;
Oshkosh W1 54903-] 128. Commencing work without permit(s)wi11 resuli in fees being doubled or$]00.00 plus ihe
normal pennit fee,which ever is greater. , `
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OR E
I�vou are a con�rac�or par�icipating in the Pe�•nari fee Account S�slem and have adepuale funds, check her•e
if vou wa��t this processed lhrough vour account I—I
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**Advisory-For applicable projects, an Elecbrical 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 Issn.ance and will be returned for completion.
DATE ���z-�5 `I3
JOB ADDRESS c1���' 17����� �'I_
� OWN�R �O M tr �L�r��C.t,�1 I�� C�t� „
CONTRACTOR Narx Nechanical, Inc
CH�CK L(ALL APPLICABLE £
USE CATEGORY
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial �
FUEL �Gas ❑Electric ❑Solid SYSTEM ❑New �eplace `
❑Oil ❑Solar ❑Other
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TYP�
❑Farced Air �Radiant ❑Steam ❑A/C ❑Vent ❑�lectric ❑Hot Water ❑Suppl. ❑Co�l. Burner
IS CIiIMNEY BC1NG LIN�D �No �Yes - L1NER 517� �3�� &MANUrACTUR�R F��'�` L-
Note:All chimneys sliall be sized per tl�e BTU's being ventcd.
CHIiVINEY 7'S'PE ❑Chimney A � ❑Chimney B !�'Direct Vent L�Other _
1�Ta,AT LOSS ❑As Appr�ved f�L�isting �JNut Applicable �
�_ BTI� �tAT� ❑As Per P1an �Variable �OtLer Value ���UOI�_ Q��� 1NQL1�1� �
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ll1sSCRIPTION /SCOPL OI+ALL WORK BLING DONr �
� �L-'�+.,f�C��� Tl1t rtl�n��ae� w� � ��f�iu�x 1��� C1��h u fi o°�a xv 3b c �
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�-�����' �1-� f� �C_ v� l.r'�+Nl�� M� I:s�('k-- ��3� �-`la '�� _
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, - - - ;
VALUE(Including laboi•and mateT•ials) $ ��#U� W ___ '
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�L�CTIZICAL CONTRACTOR(for p►•ojects not requiring an EIV Fot•n�) ;
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