HomeMy WebLinkAbout0105611-HVAC105611
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
FREDERICK L PLONKA ETAL
Job AddressOwner
2104 HICKORY LN
Create Date04/03/2003
ContractorMARX MECHANICALCategory502 - Residential-BothPlan
OilElectric
üü GasSolarSolid
Fuel
üü NewReplaceOther
System
üü Forced AirRadiantSteam üü A/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue
Use/Nature
SFR/ Add ductwork and A/C to new 20' x 26' addition to the existing single family home to include 2 bedrooms and a full bathroom.
of Work
Plan Approval$0.00
Fees: Valuation$4,800.00Permit Fee Paid$77.00
Issued By:Date12/05/2003
Permit Voided
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.
SignatureDate
Agent/Owner
Address4535 STATE ROAD 91OSHKOSHTelephone Number920-235-6510
WI54904-6304
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.
17. v-'
City ofOslikosh
Divisioll ofJnspeciion Services
P.O. Bo); ] J30
Oshkosh, W} 54903- ] J 30
Phone (920) 236-5050
F.a); (920) 236-5084
EIVED~
DEe 042 ~
DEP. 003 OJI-iKOJI-j
CO;}f')U 'ARTMENr 0 O!oJ1HI WI"fl(
~VAC PERM}! APpt~Jrrl~EL04
AlllllJOrm.311011 .after boJd categoner; must be provloed. 'fNT
lncompJete1:lppJicaiion.s 'NiJJ not be processed.
App]ic3tion(s) and fce(s) can be brought to City Hajj, Room 205 or m3i1ed to JnspectiOlJ Servjces, PO Bo); ] J 28,
Oshkosh V/1 5~903- J J 28. Commencing wor]( without pem1i1.(s) wi]] result in f6es being doubled or $J 00.00 plus tl)e
11011113J pennit fee, wlDch ever is greater..
On.
}fvou are a contractor porticipatin9. in the Permit fee Acc<nwt SW:;1em and hove OdUjll.a1e fimds. check here
lfvou wont this 1J7"()I:.:f:,s-sed throus'h vour OCCOunt n
.
JOB ADDRESS a 10 L+ 1+1 C/{zOil'-( eMit!
O\VNER 0AfV\PS" IY{C,L~ tMAYZt- t\JB;Tt'~ GbNS~)
CONTRACTOR MAttY-. M-tcJ~!1CM~
DATE 1:)-:) --0 3
CHECK 0" ALL APPLICABLE
USE CATEGORY
Q-Single Family DDuplex o Multi-Family
o Rental
o Commercial
o Industlial
FUEL
m-Cas
DOil
DElec1Tic DSoJid
OSoJar
SYSTEM
lB'.K1 ew
00t1)er
OHepJace
TYPE
B"Forced Air 1~Radja111 DSteam WC o Vent DEJecblc l:JHot Water DSuppL /leon. Burner
IS CHJJ\1N1tY BItING JJoNED I~o [JYes .-LD'~n:z ~)J.ZE_H __0____ & M/\N1.JFACTURJJ<__ __.
}.:o1e.: All chimneys SJJ3JJ be SiZlod per 1be B'1'lJ's being \'t:.lJkd.
Crnl\1Nl~Y TYPE
rn:A'T LOSS
BTU RATE
DChiml1ey A
LJAs Approved
DAs Pcr Plan
[JCbimTlcy B
r.JEx.isiing
LJVariabk
rlDirect Vent [J01])er
rJ :'~ot Applicable
[JOjJw.r Value _______0___
DJtSCRlPTION OF ALL '\VOR/< HEING DONg ProD .OUC-T\AfDtZlL '+ 1t1.~~~.I]) __ _
.. ----jlEbl -- ____Afr01Ll ~ _ 0 H___ . ---=H =_ =_._-=- _=~-~. ~_.~-= :~.=.~~-___~ -._____ ___ _____
I
-.-.-
VALUE (lndudi.ng l;lbor 2nd 2ll m21erials inc.luding light fixtnres) 3; tff(j{) \~J
ELECTRICAL CONTRACTOR .0 0 o. . .. . "------
lJ For <1ppJic:obJe projects, a;;-Bi~\:I;~i~-lnst~]]atjOJ)\lerj:fjc~;li\.JJ;f;:m, Sigll~:d by the-EJec11ical ConLo3doL must be
atlached. JfJJot aitached or not applicable, 3 separate h1ecbica] Permit is required.
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