HomeMy WebLinkAbout0105032 HOSHKOSH
ON THE WATER
2300 PATRIOT LN #A
THOMPSON HEATING AND COOLING SI
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner NINA LEIB
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
105032
10/28/2003
Other
Vent J
Use/Nature Condo/Owner is adding rooms in basement. I will be providing the HVAC work.
of Work
Fees: Valuation
Issued By:
$1,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 10/29/2003
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 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.
JOb A Dm ss
CONTRACTOR
· 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 you are a contractor participating in the Permit tee Account System and have adequate funds, check her.
if you want this processed through your account Iq
CHECK [] ALL APPLICABLE
USE CATEGORY
g~Single Family F1Duplex
I-1Multi-Family [~Rental
F1Commercial
Fllndustrial
FUEL [~Gas rqElectric FiSolid
I-IOil FISotar
TYPE
~Forced Air F1Radiant FISteam F1A/C I-IVent F1Electric
IS CltlMNEy BEING LINED F1No I-lyes - LINER SIZE
Note: Ail chinmeys shall be sized per the BTU's being vented.
SYSTEM FINew FIReplace
FIOther
FIHot Water FISuppl. I-ICon. Burner
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
FiChimney A
FIAs Approved
FIAs Per Plan
F1Chimney B
F1Existing
FIVariable
F1Direct Vent
FiNot Applicable
r'lOther Value
FiOther
VALUE (Including labor and all materials including light fixtures) $ ~ d~]//f2~, fb
ELECTRICAL CONTRACTOR
E 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