HomeMy WebLinkAbout0103804-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 813 HENNESSY ST
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 THOR L/SUSAN M BAARDSEN
Category 502- Residential-Both
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 ]~ As Approved ~ Existing O Not Applicable ] Value
BTU Rate ]~ As Per Plan ~) Variable ~ Other ] Value
No
Create Date
Plan
L~ Solid
103804
08/27/2003
Other J
Vent J
Use/Nature SFR/Replace furnace & A/C.
of Work
Fees: Valuation
Issued By:
$4,641.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$75.50
Date 08/28/2003
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.
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
Fa;( ~ (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
A'll fields/information after bold categories must be p~*~xV~-EiVED
Incomplete applications will not be processed.
DATE ~-/¢-o$1ta Q ~" ,
DUPLEI
ELECTRIC
P-.~D I~T
HOT WATER
DEPARTMENT OF
OTHER
STEAM ~ VENT
ow~R ~u6 ~Sa~mo ~3
c0 EAc oR
CIRCLE ~L ~PLI~LE
USE ~.TE~ORY ~
F~L ~ OIL
SYST~ ~W
~ELECTRIC
SUPPL. CON. BURigER
IS CHII~NEY BEIN~ LINED k~D
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY A ~___~E~ DIRECT VENT
CHI~IEY
TYPE
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTURATE AS PER PLAN VARIABLE OTHERVALUE
LINER SIZE
MANUFACTURER
OTHER
NA'~'u~E OF WORK:
,VALUE (Includin~ labor and materials) $ ~~ ¢I/
ELECTRICAL CON~_RACTOR /~-~J~q~- ~L&'¢TTZ_~ ¢_
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation Fees
$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
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.