HomeMy WebLinkAbout0158676-HVAC (furnace) /�"� CITY OF OSHKOSH No 158676
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD :
ON THE WATER
Job Address 523 N LARK ST Owner WALTER A PAYNE Create Date 11/OS/2013
Contractor ROBY'S HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel ✓ Gas _ � Oil � Electri� Solar Solid
System New � 0✓ Replace � � Other �
�Forced Air � Radiant _ Steam� A/C Vent �
Electric Hot Water I Suppl. � Con. Burner
_ -__ --- -- - - -..
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
. _ -- --__-.
--- ----- _ - - ----
Heat Loss As Approved � Existing � Not Applicable ' Value
- ___ _ ---- ---�
BTU Rate As Per Plan � Variable � Other _� Value _ _ 60,000
Use/Nature FR/REPLACE FURANCE
of Work
I
I
i
� - - -�
Fees: Valuation $2,850.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: �� Date 11/08/2013
� Permit Voided 'I Parcel Id#1604580000
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 ,�-,�n Date � 1- a- i3
� Agent/Owner
Address 317 HAMBURG ST RIPON WI 54971 -1308 Telephone Number (920)428-1381
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
F� (920)236-5084 O�u�/O�u
I II\ I I
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$100.00 plus the
normal permit fee,which ever is greater.
OR
11 vou are a contractor narticinatin� in the Permit fee Account Svstem and have adequate }'unds check here
If vou want this nrocessed throu�h vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for iustallations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications snbmitted without an EIV when such is reqnired, will not be
processed for Permit Issaance and will be retarned for completion. :
DATE I I'�- U
JOB ADDRESS �-Z 3 � ��� I�5-�'
OWNER (�J�- I d't-' ?�t v�%�
CONTRACTOR „o�i_S ��t�:�-i r,� �'C��-�I�'r�
CHECK�ALL APPLICABLE
USE CATEGORY '
'�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL Cz�Fas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
�Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ONo �Yes -LINER SIZE &MANLJFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved �xisting �Not Applicable
BTU RATE ❑As Per Plan ❑Variable C}�Other Value 1�����' ?g7U
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ��P/.�y r..�.H�c
VALUE(Including labor and materials)$ �-�7J
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o�/o�