HomeMy WebLinkAbout0105257-HVACOSHKOSH
ON THE WATER
.lob Address 457 W 14TH AVE
Contractor TENTH STREET STATION INC
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Owner GARY F/MARY GRAY
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
105257
11/11/2003
Other J
Vent J
Use/Nature SFR/Add 2 supply runs to new 16' x 18' addition off the rear of the house.
of Work
Fees: Valuation
Issued By:
$460.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 11/11/2003
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 924 OHIO STREET OSHKOSH WI 54902 -0 Telephone Number
236-8770
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.
~FRON ~TENTH STREET STATION, INC. FAX NO. :920-236-0150 Nov, 10 2~83 09:29AM P1
Ci~ of Oskkosh
Division oi~Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone {920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information afze~ bold categories must be provided.
Incomplete applications will not be pmcosse, d.
· Application(s) and fe~(s) canbe brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commoucing'work without'permi}(s) will result in fas b*ing doubled or $100.00 plus the
normal permit fee~ which ever is greater.
OR
If ¥o~ are a contractor particit~atine in the Permit fee Account System and have hdectuate funds, check here
if you want thL~ processed through your account ~-~
CHECK I~ ALL APPLICABLE
USE CATEGORY
li~'$ingle Family [2Duplex
ElMulti-Fami!y. I=]Remal
E]Com~chl
Dlndustrial
FUEL ' ~'Gas nElectric DSolid SYSTEM
FIOil . ElSolar
T'E
~Fo~c~d Ah' ElRadiant FISt~am EIA/C ElVent F1Electrie
cma mV - sIz
Note: All chimneys shall be s/zed perfl~ BTU's being vemexl.
· "CHIMNEy TYPE rlChimneyA t:lChimncy B
HEAT LOSS rqAs Approved nExisting
BTU RAT~ nas P~r Plan nVariable
O~,SCi~ZT~O~ OZ ~.~- WOl~ BZIN(; ~O~- '~-~
[~Replace
CIHot Walcr IZlSuppl. ~Con. Bm'ncr
& MANUFACTURER
[3Direct Vent I~th~r
EINot Applicable
~Other Value
' VALUE (Including labor and ail materials including light fixtures) $
ELECTRICAL CONTRACIOR ~/
~ For applicable projeota, aa Electho Installation Verification form, signed by the El~Wical Contrai:tor, must be
attached. If not attached ornot applioable, a separat, Ele~.zi~al Permit is r~quired.