HomeMy WebLinkAbout2003-HVACOSHKOSH
ON THE WATER
.lob Address 491 S WASHBURN ST
Contractor CENTRAL HEATING SERVICE INC
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 DUMKE & ASSOCIATES LLC
Category 512- Ind. & Comm-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type
Heat Loss
BTU Rate
IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
IO As Approved ~ Existing ~ Not Applicable I Value
I~ As Per Plan ~ Variable ~) Other I Value
No
Create Date
Plan
~ Solid
99390
11/14/2002
Other
Vent J
Use/Nature
of Work
i VAC for First Federal.* Late fee assessed because this work had commenced prior to permit issuance, while HVAC plans were approved with
e building plans. (AD)
Fees: Valuation
Issued By:
$62,500.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$617.50
Date 01/08/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1565 HARRISON STREET OSHKSOH WI 54901 -0
Telephone Number
(920) 235-6670
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
OWNER
CONTRACTOR
, e RECEIVED
· JAN 0 8 ?on
DEPARTMENT OF
HVAC PERMZT APPL?CAT'r UN TYDEVELOPMENT
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
CIRCLE ALL APPLICABLE
USE CATEGORY
FUEL ~ OIL
SYSTEM ~
TYPE
ELECTRIC
SINGLE FAMILY DUPLEX
ELECTRIC
REPLACE
RADIANT
HOT WATER
MULTI-FAMILY ~
SOLAR SOLID
OTHER
STEAM A/C
SUPPL.
IS CHIMNEY BEING LINED LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B
HEAT LOSS ~ EXISTING
BTU RATE ~ VARIABLE
NATURE OF WORK:
VALUE (Including labor and materials) $ G,,',,~) ~ D
ELECTRICAL CONTRACTOR
Electrical installation of new/replacement equipment shall be
contractors.
Valuation
INDUSTRIAL
VENT
CON. BURNER
MANUFACTURER
DIRECT VENT OTHER
NOT APPLICABLE
OTHER VALUE
by licensed
$0 to $1,000.00 .................................................... ; ................................................................................. $20.00
$1,000.01 to $!0,000.00 ............................................................................................................... $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 $!.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.