HomeMy WebLinkAbout0104638-HVAC � ' CITY OF OSHKOSH No 104638 :
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OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
DEC 2003 i
ON THE WATER ���TG, - `'
Job Address 1565 GALWAY CT Owner RICHARD W/SUSAN LEIB Create Date 09/23/2003
Contractor THOMPSON HEATING AND COOLING S Category 500-Residential-Heating&Ventilating Plan
Fuel ✓ Gas Oil � Electric � Solar Solid �
System ❑ New I � Replace � Other
✓ Forced Air Radiant � Steam A/C Vent �
Electric Hot Water � Suppl. U Con.Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss �As Approved Existing + Not Appiicable Value 0
BTU Rate As Per Plan Variable Other Value
Use/Nature SFR/Adding heat runs to a 16'x16'family room addition off the rear of the house.
of Work
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: � Date 10/07/2003
� Permit Voided ,
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 e�sement,the City sVongly urges the permit applicant to contact the easement
holder(s)and to,secure any necessary app �a�s before starting such activity.
Signature e �e,.,�/�r.�-` �,��"---_ v �c.�ti���i�--� Date � � �
Agent/Owner
Address 901 OTTER Oshkosh WI 54901 -0 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, 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
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-I 128. 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 you are a contractor participating in the Permit £ee ,qccount System and have adequate funds, .check here
if you want this processed through your account ~
JOB DDHEss
CONTRACTOR
CHECK gt ALL APPLICABLE
USE CATEGORY
J~Single Family [2Duplex [2Multi-Family
F1Rental UlCommercial Fllndustrial
FUEL ~g~Gas FiElectric FiSolid SYSTEM VINew FIReplace
F1Oil F1Solar FiOther
TYPE
~Forced Air FiRadiant FiSteam FIA/C [3Vent . [3Electric F1Hot water FISuppl. F1Con. Burner
IS CHIMNEY BEING LINED F1No [3Yes - LINER SIZE
Note: Ail chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
ItlgAT LOSS I-lAs Approved I-IExisting [3Not Applicable
BTU RATE F1As Per Plan I-IVariable V1Other Value
[3Chimney A FiChimney B [3Direct Vent [3Other
VALUE (Including labor and all materials including light fixtures) $ ~ /~--'"~J"~, ~
ELECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
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