HomeMy WebLinkAbout0104853-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 453 W 18TH AVE
Contractor MARX MECHANICAL
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner GWEN E GROSSKOPF
Category 502- Residential-Both
L~ Electric
New ] ~] Replace ]
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~) Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss ]~ As Approved ~ Existing O Not Applicable ] Value
BTU Rate ]~ As Per Plan ~) Variable ~ Other ] Value
No
Create Date
Plan
~ Solid
104853
10/20/2003
Other ]
Vent
Use/Nature SFR/Replace furnace and A/C. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$4,435.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$72.50
Date 10/20/2003
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
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number
(920) 235-6510
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
· Application(s) and fee(s) cm~ be brought to City Hall, Room 205 or mai]ed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) wit] result in fees being doubled or $100.00 plus the
normal permit fee, wt~d~ ever is g~eater.
OR
~f vou are a co~tractor par~icipatin~ in the Permi~ fee Accoun~ System and have adequate [u~tds, check here
if you wan~ ~his processed ~hrough Vour account ~
CONTRACTOR
cYrv, CK ~ ALL APPLICABLE
USE CATEGORY
X~Single IZIDuplex 13Multi-Family
Family
t3Rental F1Comaaercial Dlndustrial
FUEL "j~ Gas UlBlectric E]Solid SYSTEM
[Oii []Solar
[New ~Replace
[Other
TYPE
~LTForced Air 13Radiant [Steam ~2~A/C []Vent [Electric [Hot Water [Suppl. 13Con. Burner
IS C]~NEY BEING I,INED E]No i3Y~es - LENER SIZE
Note: All cI4mneys shall be sized per the BTU's bei~*g vented.
& MANUFACTURER
CItIN[NEY T'kgPE
ItlgAT LOSS
BTU RATE
[Chinmey A
L~As Approved
[]As Per Plan
[2Chimney B
[] Existing
~Variable
[5Direct Vent
[]Not Applicable
[]Other Value
[O~aer
ELECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, sigaxed b5 the Electrical CnntractoL must be
atlached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
10/tg/900 ~! 19' 3Y o .....
Elecbvic Installation Verification
(We) B_~z El_ectrlc~ Inc, .
52._~1W. 12th O~hkosh WI~ ~
have b~ contracted to p~ri'orm electric in~iallaIion work for !!!a_ia_ia_ia_ia_i~x Me~hani~
atthe followi~ address: 4_53 tN 18th Av~xtl~.
Tile nature of the work confists of: (Check One or Describe the Nature of Work)
R~onne¢tion or n~t circuit for replavcment Heaing plant and/or A/C Condonser.
Kecmme~on or new ~-ircuit for replacement Electric Water I-~ater.
R. econnection of the Service Entrance Cable, M~ter Box, alterafiom to r~copt~ole~ and
ligl~ng fixtures date to siOing I ~ot~it installation, No~e: New Serfice Entrmace Cables
w~ll require a s~am~e permit.
[] geeoaneetion or new eir~ait for oth~ permanently wired applia~.ees t fixture~,
[] Other
The value oft3is work is
,, ,. ,~..~,, ~. -~,...h~'.'t.e ;'~this cortlpaw ami ~rtl~r'~eri~ the
I hereby verify this work will be p~-~:-~ -5 -- ~--~": ' " and Electric code
,econneotion ! t~s~ati~ ~ be done in compli~ce wi~
reqdrm~s.
D ger