HomeMy WebLinkAbout0158602-HVAC (boiler) � CITY OF OSHKOSH No 15sso2
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1110 OREGON ST Owner JOSEPH A FREEBERG Create Date 11/05/2013
Contractor BETTER HOME HEATING&AIR CONDII Category 500-Residential-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel ✓ Gas I Oil j Electric � Solar Solid
System [] New j � Replace i � Other
�
Forced Air � Radiant � Steam A/C � Vent
Electric ✓ Hot Water j SuppL Con. Burner i
�
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature �Boiler is being replaced
of Work '
'Paid with check
�I
- �
Fees: Valuation _ $6,850.00 Plan Approval $0.00 Permit Fee Paid $126.00
Issued By: Date 11/05/2013
❑ Permit Voided ', Parcel Id#0302820000
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 1054 AMERICAN DR NEENAH WI 54956 -1305 Telephone Number 920-733-2161
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
Fax (920)236-5084 O�HKO�H
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 �artici�atinQ in the Permit fee Account Svstem and have adequate {i�nds, check here
if vou want this processed 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 submitted
: with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be reiurned for completion.
DATE,�/U �c3�—l.�
JOB ADDRESS I � �'
ovvlvEx - -- � RECE�V�' �
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CONTRACTOR � /o��. GG :
� NOV 0 4 2013
CHECK H ALL APPLICABLE
DEPART�1E\7 OF
U�S�'CATEGORY INSP CTION SERVICES Df\'SION
C�3'Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FiJEL Lz(Gas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
T `
ed Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric �Water ❑Suppl. ❑Con. Burner
IS C�IIIVINEY BEING LINED ❑No ❑Yes -LINER SIZE &MANLTFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIlVINEY 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 �/D ��1�
VALUE(Including labor and materials) $ ��JV- U�
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
� � �_ 9�.�—% o�,o�