HomeMy WebLinkAbout2013-HVAC � CITY OF OSHKOSH No 159162
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 543 SCHOOLAVE Owner HABITAT FOR HUMANITY OF OSHKOSH II Create Date 11/27/2013
Contractor GRANT SCHULTZ HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas� Oil � Electric ,i Solar �I Solid
System �✓ New _� Replace _ � � Other :
✓ ForcedAir Radiant j Steam _J� A/C � Vent
Electric ' Hot Water Suppl. I Con. Bumer j
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable ;
Heat Loss As Approved � Existing � Not Applicable Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature NSFR\LATE PERMIT/Heating for new habitat house ��debit acct ;
of Work �
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Fees: Valuation $4,200.00 Plan Approval $0.00 Permit Fee Paid $194.00 .
Issued By: ��Lv Date 12/27/2013
❑ Permit Voided Parcel Id#0201230000
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 55 CRIMSON LN OSHKOSH WI 54902 -7298 Telephone Number (920)216-1616
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 Osllkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OlHKO.lH
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
� I �ou are a contractor artici atin in the Permit ee Account S stem and have ade uate unds check here ��
� i ou want this rocessed throu h our account �
**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 snbmitted
with the permit application. Applications snbmitted without an EIV when such is required, w' 1 not be
processed for Permit Issnance and will be returned for completion.
��� DATE �Z Z � �3
JOB ADDRESS �-""�l
OWNER a bT T � �tif j �j -
CONTRACTOR l`7�('�y/1 � �G�I+C 6� ry��`j�i
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CHECK�ALL APPLICABLE
USE CATEGORY
�1Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL �Gas ❑Electric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
T�E
�(Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED C�No ❑Yes -LINER SIZE &MANUFACTURER
Note:Ail chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE Chimney A ❑Chimney B irect Vent ❑Other
HEAT LOSS s Approved ❑Existing Not Applicable
BTU RATE As Per Plan ❑Variable ❑Other alue
DESCRIPTION/SCOPE OF ALL WORK BEING DONE f��I//
VALUE(Including labor and materials) �D�'`�
.
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ��v/' ` [ ��/�/C
o�/o�