HomeMy WebLinkAbout0102753-HVAC (a/c)OSHKOSH
ON THE WATER
,Job Address 131 W 21ST AVE
Contractor G L R COMPANY
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner JAMES G DAVIS
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102753
07/07/2003
Other
Vent J
Use/Nature SFR/Install A/C.
of Work
Fees: Valuation
Issued By:
$1,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$23.00
Date 07/11/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 4860 COUNTY ROAD K OSHKOSH WI 54904 -0
Telephone Number
(920) 233-0784
Division of Inspection Services
2iS Church Avenue
P.O. Sox 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
9hone (920) 23~-5048
Co c roR h, C.. o
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
CIRCLE ALL APPLICABLE
GLR Company
4860 Cty. Rd. K
Oshkosh, WI 54904
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY COMMERCIAL INDUSTRIAL
NEW REPLACE OTHER
TYPE FORCED AIR RADIANT STEAM ~ VENT
ELECTRIC HOT WATER SUPPL.: ,. CON~ BURNER
Note: All chimneys shall be sized per the BTU's being ~nted ~;~.~
CHIMNEY~YPE ~ CHIMNEY'A CHIMNEY B ~ '~
H~AT LOSS AS APPROVED, .... ~;'~;~ EXISTIN~ NoT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK:
VALUE (Including labor and materials) $ /~OO--
ELECTRICAL CONTRACTOR ~ (.~3~-%~ ~_
Electrical installation of new~lacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 to $1,000.00 ................................................................................................................................... $20.00
$1,000.01 to $t0,000.00 ............................................................................................................. $20.00 for first
~ ~: i~ $1,000.00 plus $i[1-5~ :~ $!00.00 valuation or'part thereof
$!D,000<.0!~o $25,000.00..~..., ............................ ~ ........... .... ~ ..................................... $155.00 for f~irSt
$10 000.00 plgs $1.,00 per $100.QO valuation or part thereof
Over$25,~000.00.~,....,.i..'..A2l .................................. ~b~.~..~,~.i.m .................................................. $305.00 plus $0.50
pe~r $100~00 valuation or part thereof
· Submit payment with application. Failure to pay within. 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.