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HomeMy WebLinkAbout2003-HVACOSHKOSH ON THE WATER .lob Address 515 N SAWYER ST Contractor Fuel ~J Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD FOREMEN HEATING & VENTILATING IN< Oil Forced Air I ~J Radiant Electric I ~J Hot Water Owner EFRAIN J LOPEZ LLC Category 512- Ind. & Comm-Both L~ Electric Replace L~ Steam L~ suppl. No 99406 Chimney Type I~ ChimneyA ~ Chimney B Heat Loss IO As Approved ~ Existing BTU Rate IO As Per Plan ~ Variable Direct Vent Create Date 01/03/2003 Plan G5-111-1202 Not Applicable Other Solar I ~J Solid ~J Other A/C I ~J Vent Con. Burner I Not Applicable Value Value Use/Nature RESTAURANT/HVAC for dining room addition. of Work Fees: Valuation Issued By: $10,900.00 Plan Approval $0.00 Permit Fee Paid Permit Voided $164.00 Date 01/09/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 819 MORLEY RD P O BOX 10073 GREEN BAY WI 54307 -73 Telephone Number 1-920-499-6969 Division of Inspec%ion Services 215 Church Avenue P.O, Box 1130 Oshkosh, WI 54903-1130 Fax # (920) 236-5084 Phone (920) 236-5048 All JAN 0 2 20o} -HVAC PERMIT APPLI:ATION fields/information after bold catego..ies taus% ' Incomplete .... applications will not be processed.~U~ CIRCLE ALL APPLICABLE USE CATEGORY SINGLE FAMILY DUPLEX FUEL ~S ) OIL ELECTRIC SYSTEM REPLACE TYPE ~CED~ RADIANT MULTI-FAMILY ~ INDUSTRIAL SOLAR SOLID OTHER SUPPL. CON. BURNER IS CHIMNEY BEING LINED LINER SIZE Note: Ail chimneys shall be sized per the BTU's being vented. CHIHNEY TYPE HEAT LOSS BTU RATE CHIMNEY A NATURE OF WORK: CHIMNEY B EXISTING VARIABLE ~ C DzRE~T VENT NOT APPLICABLE OTHER VALUE MANUFACTURER VALUE (Including labor 'and raaterfals) $ ELECTRICAL CONTRACTOR Electrical installation of new/replacemen~ equipment shall be done by licensed contractors. ~/~~~~_ $0 to $1,000.00 .................................................................................................................................... /ko z_ $1,000.01 to $10,000.00 ............................................................................................................. S20.00 for first Sl,000.00 plus S1 50 per S100.00 valuation or part Ehereo- Sl0,000.01 to $25,000.00 ............................................................................................................ $155.00 for firs5 $10,000.00 plus S1.00 per S100.00 vaiuaEion or paru thereof Over $25,000.00 ..................................................................................................................................... $305.00 plus S0.50 per $100.00 valuation or part thereoi · Submit payment with application. Failure no pat, with:in 30 days will resu].t an fees being doubled or Sl00.00 plus the normal pertain lee, which ev/e,r is~ ~ ~_