HomeMy WebLinkAbout0099310 HOSHKOSH
ON THE WATER
.lob Address 620 N SAWYER 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 JAMES J/BRENDA SMITH
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO ChimneyA ~ Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan O Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99310
12/19/2002
Other
Vent J
60m
Use/Nature SFR/Replace furnace & add A/C. *EIV form from Heritage Electric.
of Work
Fees: Valuation
Issued By:
$5,190.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$83.00
Date 01/06/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0
Telephone Number
(920) 426-2654
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
CIRCLE ALL APPLICABLE
FUEL /G~S~ OIL ELECTRIC
SYSTEM NEW ~~
TYPE ~.~. RADIANT
MULTI-FAMiLY
SOLAR
OTHER
STEAM
ELECTRIC HOT WATER SUPPL.
IS CHIMNEY BEING LINED ~, -~'~ ~v~INER SIZE
Note: All chimneys-shall be sized per the BTU's being vented.
CHIMNEY TYPE C~~ CHIMNEY B
HEAT LOSS AS APPROVED S
BTU EATE AS PER PLAN ~~
COM~ERCiAL
SOLID
I~DUSTRIAL
VENT
CON. BURNER
MANUFACTURER
DIRECT VENT OTHER~
NOT APPLICABLE
OTHERVALUE~~69
RECEIVED
.VALUE (Including labor and materials) $ ~///~9. ~
ELECT~iC~ CO~CTO~ //~////~ ~J/~//~/r I JAN 0
Electrical installation of new/replacement equipment shall be done by icensed
contractors. DEPARTMENT OF
' ~ ~ ~ DEVELO?~ENT
Valuation
$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 $0.56'.
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.
12/18/2882 06:56 9287343838
HERIT~E
(Et~trical Contractor Name)
~__.~- ~/~'~,~ ~~ ~. ~ c~
(A~ss) (ci~) '~s~) (zip c~)
(Ad~ns whcr~ work will ~ ~~) ..... ' .....
R.con~ion or new ¢ircufit for replacement H~ P~ ~ ~C CaUser,
R~o~on ~ new c~cm~ for rcpl~ ~c W~ H~.
~o~on or n~ civil for o~ p~~y
T~ ~ed~e of tl~s work is $
I hereby verify this work will be pm'i'ormnd by an employee oft~$ eompnny and furt~ vv4~y ~
recotmcction / installation will be done in complia.~e with m~.nufnoturer arid Eleclric cod~
($~atuze of Come,my Offle~J~:~'
(?r~t .Nl~nc of Oflic~r)