HomeMy WebLinkAbout0103237-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 1317 BISMARCKAVE
Contractor DRUCK'S PLBG & HTG & CLG
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner FRANK H GAAB
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A O Chimney B ~) Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~) Other I Value
No
Create Date
Plan
L~ Solid
103237
07/31/2003
Other
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Heritage Electric.
of Work
Fees: Valuation $2,379.00 Plan Approval $0.00 Permit Fee Paid $41.00
Issued By: Date 07/31/2003
Permit Voided J
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0
Telephone Number
(920) 426-2654
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.
Division of Inspection Services
215 Church Avenue
P.O. BOX 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
All fields/information after bold categories must be provi~e]~.
Incom lete a llcatlons will not be rocessed
p pp . . p .
CIRCLE A3~L APPLICABLE
USE CATEGORY ~LE~
FUEL
SYSTEM
TYPE
CHIMNEY TYPE
HEAT LOSS
BTU RATE
NATURE OF WORK:
DUPLEX MULTI-FAMILY
~ OIL SOLAR
NEW OTHER
IS CHIMNEY BEIN~ LINED ~/~ LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY A ~
AS APPROVED ~I'STING~
ELECTRIC
P-.~D I~?
~ATER
COMMERCIAL
SOLID
A/C VENT
CON. BURNER
MANUFACTURER
INDUSTRIAL
OTHER
DIRECT VENT
NOT APPLICABLE
OTHER VALUE
.VALUE (Includin~ labor and ~terials) $~//- O~
ELECTRICAL CONTNACTOR ///[,~///~ ~'~/'~/~'
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation Fees
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
~reater.
$0 tO $1,000.00 ............................................................................................................... $20.00
$1,000.01 to $10,000.00 ..................................................................................... $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 ............................................................................................. $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ............................................................................................................. $305.00 plus $0.50
per $100.00 valuation or part thereof
DRL'C~$
Electric Installation Vermcatlon
Tim ~ of tl~ work coa~d, sts of: (Check One or De~ribe h~c Na~ of Work)
The v~lue of this work is $ ...... ,
i h~r~,by veti~ this work will Ira: I~rformcd by mn cmployml~ of this comp~my and fu~hm Verity
~o~ection / ~s~la~ will be done ~ complimce ~ m~ ~d ~l~c ~de
~uir~e~s,
(Print No/r~¢ of