HomeMy WebLinkAbout0097559- HVAC (Furnace/AC) y 0 CITY OF OSHKOSH No 97559
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 941 N LARK ST Owner MATTHEW I JENKINS Create Date 09/25/2002
Contractor CUSTOM HEATING&COOLING Category 500-Residential-Heating&Ventilating Plan
Fuel ✓I Gas Oil I Electric I Solar IA Solid
System n New I [✓ Replace I ❑ Other j
u Forced Air u Radiant Li Steam u NC a Vent
I Electric I Hot Water I Suppi. Li Con.Burner
Chimney Type Q Chimney A Q Chimney B Q Direct Vent • Not Applicable
Heat Loss Q As Approved 0 Existing • Not Applicable Value 0
BTU Rate Q As Per Plan Q Variable • Other Value
Use/Nature SFR/Replace 80m btu furnace&add 2 ton central a/c. *EIV form from Hoehne Electric.
of Work
Fees: Valuation $2,900.00 Plan Approval $0.00 Permit Fee Paid $48.50
Issued By: V...\NA Date 09/25/2002
❑ Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0 Telephone Number (920)235-7263
•
City of Oshkosh V�
!! )
Division of Inspection Services ��
P.O.Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 OJHKOJH
ON THE WATER
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 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 n
DATE 5_,R4/40c:9-3
JOB ADDRESS 9t? / '!C
OWNER VED
CONTRACTOR � SEP 2 5 2002
CHECK 0 ALL APPLICABLE COMMON ARTMENT OF
TY DEVELOPMENT
USATEGORY
(QSingle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL 06a7-s-
❑Electric ❑Solid SYSTEM ❑New ®'Replace
❑Oil ❑Solar ❑Other
T
orced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner
2Cr
IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE 3 &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value /,
DESCRIPTION OF ALL WORK BEING NE / { & i& /C/
r ✓
VALUE (Including labor and all materials includin light fixtures) $ Clllec'.1!2)
ELECTRICAL CONTRACTOR
❑For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor,must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
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