HomeMy WebLinkAbout0099309-HVAC (furnaces)OSHKOSH
ON THE WATER
.lob Address 600 S MAIN ST #9
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 JOSEPH C ROLOFF
Category 510 - Ind. & Comm-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99309
01/03/2003
Other
Vent J
115m
Use/Nature COMM/Replace 2 furnaces. *EIV form from Heritage Electric.
of Work
Fees: Valuation
Issued By:
$4,566.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$74.00
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 0[I ~n~~ '
P.O. Box 1130
os osh, s4903- 30
F~ ~ (920) 236-5084
PERMIT APPLICATION
Ail fields/info~ation after bold categories must be provided.
Incomplete applications will not be processed.
DATE
CONTRACTOR
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FADiILY DUPLEX MULTI-FAMiLY
FUEL G~ OIL ELECTRIC SOLAR
SYSTEM NEW R~~ OTHER
TYPE O~ '~IR~ RADIANT STEAM
ELECTRIC HOT WATER SUPPL.
IS CHIMNEY BEIN~ LINED ,,~/'~ ' LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS E~TI~
BTU RATE VARIABLE
CHIMNEY A
AS APPROVED
AS PER PLAN
A/C
SOLID
VENT
CON. BURNER
MANUFACTURER
DIRECT VENT OTHER
NOT APPLICABLE
OTHERVALUE//5~9
.VALUE (Including labor and materials) $ ~3~'-pD
ELECTRICAL CONTRACTOR//~/'/, ~w'~/ ~-~'~//f/t-
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
$t0,000.00 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.
~. 12/i~/2002 i4: 0t 920?343838 HERITAGE P~
Eiectric. InataUatto~ Verification
O/l~e,n/Con~-a~or N~me)
Oqal~ of pm'W~~] tv)
The nar~re of the work c,~m/~ of: (Ch~k One ~ D~rib~ th~ N~ of Wodt)
~r, onn~on or ~~/'or mpl~ Heatin~ Plant =~_'~= ~='C ._ ~__.. ~.
R~~on Or n~w ~tc~t for r~l~t
Re~on or new CiVet ~o~ o~e~ p~tly
The value of this work is $
reco~n t i~~ will be done
(Signature of'Company
Name