HomeMy WebLinkAbout0102728-HVACOSHKOSH
ON THE WATER
,Job Address 3342 LOUISE CT
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GRANT SCHULTZ HEATING & COOLING
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CHAD/TONYA HUISMAN
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
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
102728
04/29/2003
Other J
Vent J
Use/Nature NSFR/Install HVAC system in new home.
of Work
Fees: Valuation
Issued By:
$5,450.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$87.50
Date 07/09/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1411 S MAIN ST Oshkosh WI 54902 - 6519 Telephone Number
(920) 216-1616
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) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box I 128~
Oshkosh WI 54903-! 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
l£vou are a contractor participatin~ in the Permit fee Account System and have adequate funds, check here
i£¥ou want this processed through your account [~
CHECK [] ALL APPLICABLE
USE CATEGORY
[j[S,~ ingle F am, i~2~ nDuplex [3Multi-Family [2Rental [2Commercial [2Industrial
FUEL ¢~3as' nElectric []Solid SYSTEM []New []Replace
[] Oil [] Solar FI Other
TYPE
~tForced Air []Radiant []Steam []ADC [3Vent []Electric []Hot Water []Suppl.[]Con. Burner
IS CHIMNEY BEING LINED []No [3Yes - LINER SIZE & MANUFACTURER
Note All chimneys shall be sized per the BTU s being vented. ~
CHIMNEY TYPE []Chimney A U1Chimney B ,~]*Direct Vent []Other
HEAT LOSS [3As Approved nExisting F1Not Applicable
BTU RATE •As Per Plan []Variable []Other Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $~-'-~/e--'-/h ~'~ V'~ (-~/' ~
ELECTRICAL CONTRACTOR OR [] Electric lnstallation Verification formattached(IfReplacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02