HomeMy WebLinkAbout0099311 HOSHKOSH
ON THE WATER
.lob Address 2690 W 20TH AVE
Contractor DRUCK'S PLBG & HTG & CLG
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MARKA SEBSTEAD
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
99311
01/06/2003
Other J
Vent J
Use/Nature SFR/Replace furnace, add a/c and line chimney. *EIV form from Heritage Electric.
of Work
Fees: Valuation
Issued By:
$5,034.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$81.50
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
Ail fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
CIRCLE ALL APPLICABLE
USE CATEGORY ~GLE iFAMILY>
DUPLEX MULTi - FA~MiLY
ELECTRIC SOLAR
SYSTEM ~ R~P~ OTHER
is LI D /F./ LI ER S ZE
Note: All chimneys shall be sized per the BTU's being vented.
COMMERCIAL
SOLID
VENT
CON. BURNER
MANUFACTURER
CHIHNEy TYPE C~IMNEY~~ CHIMNEY B DIRECT VENT OTHER
AS APPROVED ~ NOT APPLICABLE
HEAT LOSS
BTU RATE
iNdUSTRIAL
AS PER PLAN
OTHER VALUE
ECE VED
.VALUE (Including labor and materials) $ ~'"~.~y.~ ~
Electrical installation of new/replacement equipment shall be done by license~
contractors. DEPART~~F
Valuation FeesCO~UN[TY DEVELOP~EN1
$o co Sz,ooo.oo ................................................................................................................................ $2o.o0
$1,000.01 to $10,000.00 .............................................................................................. $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,0O0.01 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.
:2/06/2802 ~3:00
9287343838
HERITAG~
E tr c lostallat on Verification
· ('Nme ofpatt~ contracted
R~conn~t~o~ or new circuit far ~i~em~t ~ea~ P~t ~ ~C Co~.
R~o~cti~ of~e S~ice En~ ~ble, Met~ ~x, ~o~ te r~ct~ ~d
Cables will ~u~
R~ti~ ~ new ~uit ~o~ ~~tly ~ ~pli~ /fix~
O~er
The vahte of tt~s ~vork is $
I hereby verify this work will b~
r~ecfioa~ / i:~lafion wilt
(Sil~ature of Compmay
(Pr~a( Nam~ o£Off~c4~)
(Dat~)