HomeMy WebLinkAbout0152028-HVAC (new house) � CITY OF OSHKOSH No 152028
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1847 JEFFERSON ST Owner CHADD HUISMAN Create Date 07/02/2012
Contractor THOMPSON HEATING AND COOLING SI Category 502-Residential-Both Plan
Inspector John Zarate
Fuel Gas Oil Electric Solar Solid
System � New � � Replace � � Other �
Forced Air Radiant Steam A/C Vent
Electric Hot Water Suppl. Con.Burner
Chimney Type ChimneyA Q Chimney B � Direct Vent � NotApplicable
Heat Loss AsApproved � Existing � NotApplicable Value
BTU Rate As Per Plan 0 Variable � Other Value
Use/Nature SFR(LATE PERMI�/INSTALL NEW HVAC SYSTEM FOR NEW HOME •"chekc#2945
of Work
Fees: Valuation $4,300.00 Plan Approval $0.00 Permit Fee Paid $174.50
Issued By: ��,,,) Date OS/29/2012
�
❑ Permit Voided � Parcel Id#1503930000
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 ' application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)an o ure any necessary appr ore starting such activity.
Signature Date � �
enUOwner
Address 901 OTTERAVE OSHKOSH WI 54901 -5444 Telephone Number 920-426-3095
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Finai,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�HK01H
� 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 participatinQ in the Permit fee Account Svstem and have adequate funds 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 returned for completion.
DATE O� a
JOB ADDRE S :���� �G=����`-'
OWNER /S N
CONTRACTOR ��l�G(7�Sc�iv ,Z"�7`�/�t,.E,
CHECK�ALL APPLICABLE
�E CATEGORY
ingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL C�as ❑Electric ❑Solid SYSTEM �INew ❑Replace
❑Oil ❑Solar ❑Other
TYPE
Iy�orced Air ❑Radiant ❑Steam �A/C ❑Vent ❑Electric ❑Hot Water OSuppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANiJFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A OChimney B �Direct Vent ❑Other
HEAT LOSS f�As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable �Other Value� Q'd'd
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ,G�i�CI S'�i� ��
VALUE (Including labor and materials) $ ��� � �
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)_s� 7—�-
o�/o�