HomeMy WebLinkAbout0099260-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chim ney Type
Heat Loss
BTU Rate
Use/Nature
of Work
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No
99260
2331 SHORE PRESERVE DR
MERWIN OIL CO INC
[] Gas
[] New I
Forced Air j J~ Radiant
Electric I E~]-Hot Water
Chimney A ~ Chimney B
As Approved ~ Existing
As Per Plan ~ Variable
Owner
Category
GRUNDY ENTERPRISES
502 - Residential-Both
[~lectric
[] Replace
L-J steam
[] Suppl.
Create Date 10/16/2002
Plan
~' Solar ] ~ Solid
I [] Other
~ NC I I~1 Vent
E~--Con. Burner 1
Direct Vent (.~ Not Applicable I
(...) Not Applicable I Value
(.~ Other I Value
NSFR/ Install heating & cooling system for new home.
Fees: Valuation
Issued By: '~
$6,876.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided J
$108.50
Date 01/02/2003
In the performance of t~is,~/ork, I aj;~eeJo I;~erform all
Signature V
work pursuant to rules governing the described construction.
Date
Agent/Owner
FOND DU LAC WI 54936 -68 Telephone Number
Address P O BOX 68
920-929-6100
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON TNE WATER
· 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 ['-]
l,n
' .
CONTRACTOR ~--/cot~ '~ (2 t //
CI-IECK [] ALL APPLICABLE
USE CATEGORY
[]Single Family FlDuplex
F1Multi-Family
VIRental F1Commercial nlndustrial
FUEL I~Gas VIElectric []Solid
FIOil F1Solar
SYSTEM [3New FIReplace
[]Other
TYPE
!~Forced Air [:]Radiant V1Steam I~IA/C EVent VIElectric
VIHot Water []Suppl. []Con. Burner
IS CHIMNEY BEING LINED []No []Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
I-[EAT LOSS
BTU RATE
[]Chimney A
l~As Approved
[]As Per Plan
F1Chimney B
V1Existing
VIVariable
l~Direct Vent
[]Not Applicable
[]Other Value
[]Other
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
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