HomeMy WebLinkAbout0105421-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 623 E IRVING AVE
Contractor ADONIS HEATING AND COOLING
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ZACHARY D/GENE MALNORY
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
105421
11/21/2003
Other
Vent J
Use/Nature MULTI-FAMILY/623A/ Replace furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$38.00
Date 11/21/2003
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 W2707 County Rd H Pine River WI 54965 -0 Telephone Number
685-0458
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) end 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 ~
DATE / (' --~ / r~ ~
CHECK I~ ALL APPLICABLE
USE CATEGORY
[2Single Family
FUEL ~Gas
I:]Oil
V1Duplex ~]Multi-Family VlRental UCommercial VlIndustrial
[]Electric []Solid SYSTEM []New [~l~ce
[]Solar []Other
TF~orc~'d Air []Radient I~Steam []A~C []Vent []Electhc []Hot Water F1Suppl.
IS CItIMNEY BEING LINED []No DYes - LINER SIZE & MANUFACTURER
Note: All chinmeys shall be sized per the BTU's being vented.
CHIMNEY TYPE []Chimney A []Chimney B ~reCt Vent FIOther
H EAT LOSS FIAs Approved F1Existing r-INot Applicable
BTU RATE I-lAs Per Plan []Variable []Other Value
[]Con. Burner
DESCRIPTION OF ALL WORK BEING DONE /N'5/~ 2_ (_ td~/Ufl C
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR ~
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Conlractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
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