HomeMy WebLinkAbout2003-HVAC (chimney)OSHKOSH
ON THE WATER
.lob Address 631 SCHOOL AVE
Contractor
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
BLACK CAT CHIMNEY SERVICE & CONC
Oil
Owner FORREST K REINKE ETAL
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
103983
09/05/2003
Other
Vent J
130m btu
Use/Nature SFR/Tear down chimney to roof - rebuild & reline. Fix flashing.
of Work
Fees: Valuation
Issued By:
$650.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 09/05/2003
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 PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number
(920) 279-0197
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.
OSHKOSH
ON THE WATER
Job Address 631 SCHOOL AVE
Contractor BLACK CAT CHIMNEY SERVICE & CONI Category
Fuel [~ Gas 1 [] Oil ~ I I Electdc
System [] New I ~ Replace
~j Forced Air L~J Radiant I L~ steam
] ]Electric I [~ HotWater ~ ] I Suppl.
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner FORREST K REINKE ETAL
500 - Residential-Heating & Ventilating
No 103983
Create Date 09/05/2003
Plan
[] Solar 1 ~- Solid
J E~ Other
~J ~c LJ vent
[,, I Con. 8umer r
Chimney'lype ~..~ ChimneyA ¢~ ChimneyB ~1 DirectVent (~ NotAppliceble I
Heat Loss ~ ~ As Approved (.) Existing O Not Applicable I Value 0
BTU Rate ~ As Per Plan ~ Variable O Other I Value 130m btu
Use/Nature SFPJ Tear down chimney ta roof- rebuild & reline. Fix flashing.
of Work
Fees: Valuation
Issued By; ¢ [~'~,
$650.00 Plan Approval $0.00 Permit Fee Paid $20.00
Date 09/05/2003
[] Permit Voided
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 restdctioos of which it is not a party, if you perform the work
described intthis permit,,a/pplicetion within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and/to sec4re Cny necessary appre~vals before starting such activity.
Signaturek~~¢,/~,~ /_%~¢/~/~-~/ Date ¢ ._~ '~---~ ~'~
Agent/Owner
Address PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number (920) 279-0197
To schedule inspections please calf 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.
City of Oshkosh
Division of Inspection Services
?.O. Box 1130
Oshkosh, WI 54903-t 130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/ _
HVAC PERMIT APPLICATION
Ail information after bold categories must be provided.
Incomplete applications wilt not be processed.
Application(s) and fee(s) can be brought m City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) w/ll result in fees being doubled or $100.00 plus the
normal permit fee, which ever, is greater.
OR
~ou are a contractor participating in the Permit fee Account System and have &dequate fund& check here
if you want this processed thr_ough your account
DATE
JoB ADD ESS [:'.Y/
¢ONTRACTOR_~/q~ ~."~
CHECK ~ ALL APPLICABLE
USE CATEGORY
~Single Family [qDuplex
ElMulti-Family FqRental
ElCommercial
ElIndustrial
FUEL l~Gas F1Electric E]Solid SYSTEM
fi]Oil fi]Solar
fi]New fi]Replace
I~Other
TYPE
~Forced Air []$'Radiant fi]Steam fi]A/C fi]Vent fi]Elect~ic
IS CHIMNEY BEING LINED fi]No IglYes - LINER SIZE
Note: All chirmneys shall be sized per the BTU's being vented.
fi]Hot Water ~Suppl. fi]Con. Bm-ncr
CHIMNEY TYPE
HEAT LOSS
BTU RATE
UlChimmey A
[2lAs Approved
fi]As Per Plan
ElChimney B
fi]Existing
ElVariable
[~ST)irect Vent
gaNot Applicable
glOther Value
DESCRIPTIpN OF ALL WORK BEING
e . ,,'-
fi]Other
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR
G For applicable projects, an Electric Installation Vehfication form, signed by the Electrical Contractor, must be
attached, ff not attached or not applicable, a separate Electrical Permit is require&