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Home My WebLink About0104989-HVAC (pellet stove)OSHKOSH ON THE WATER .lob Address 1028 MACARTHUR RD Contractor OWNER Fuel ~J Gas ~ System ~J New ~J Forced Air 1 ~J Electric I CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Oil Radiant Hot Water Owner PAUL & DEBBIE JACQUES Category 503- STOVES AND FIREPLACES L~ Electric Replace L~ Steam Suppl. Solar A/C Con. Burner Chimney Type I~ ChimneyA Heat Loss I~ As Approved BTU Rate I~ As Per Plan Chimney B ~ Existing ~ Variable Direct Vent Not Applicable Not Applicable Other Value Value No Create Date Plan L~J Solid 104989 10/28/2003 Other Vent J Use/Nature SFR/Install a pellet burning stove. of Work Fees: Valuation Issued By: $3,000.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $50.00 Date 10/28/2003 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 1034 MACARTHUR RD OSHKOSH WI 54901 - 1434 Telephone Number 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 HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. O/'HKO/H Appiication(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 you are a contractor participating in the Permit fee Account System and have adequate funds, check here if you want this processed through your account [~ CONTRACTOR CItECK [] ALL APPLICABLE USE CATEGORY ~gle Family F1Duplex F1Multi-Family I'-lRental F1Commercial [2Industrial FUEL V1Gas F1Electric ~.Solid SYSTEM Ch~ew FIReplace F1Oil F1Solar FIOther TYPE F1Forced Air rlRadiant ViSteam FIA/C F1Vent FIElectric ViHot Water ~lSuppl. rlCon. Burner IS CHIMNEY BEING LINED VINo V1yes - LINER SIZE Note: All chimneys shall be sized per the BTU's being vented. & MANUFACTURER CHIMNEY TYPE FIEAT LOSS BTU RATE ViChinmey A r'lAs Approved VIAs Per Plan FIChimney B ElExisting ViVariable ~-Direct Vent ~l~lot Applicable -l~lOther Value ViOther DESCRIPTION OF ALL WORK BEING DONE VALVE (Including labor and all materials including light fixtures) 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. 9/02