HomeMy WebLinkAbout0098487-HVACOSHKOSH
ON THE WATER
,Job Address 4500 CEDAR VIEW DR
Contractor CONKLIN SHEET METAL INC
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
I~1 Gas I ~J Oil
[] New I
~ Forced Air i [__J Radiant
Electric I L~ Hot Water
Chimney Type ~,,~ Chimney A ~ Chimney B
Heat Loss ~ As Approved ~_~ Existing
BTU Rate ~ As Per Plan (.~ Vadable
Owner GARY GAP, BE
Category 502 - Residential-Both
[~j Electric
[] Replace
~_J Steam
U Suppl.
(.~ Direct Vent
~I Not Applicable
~t Other
Solar
Con. Bumer
Not Applicable I
Value
Value
No 98487
Create Date 07/18/2002
Plan
I L~ Solid
[] Other
J L-J Vent
Use/Nature
of Work
Install
100MBTU FA furnace with 3T A/C.
Fees: Valuation ~_~.00
Issued By:
Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$111.50
Date 11/07/2002
Date
In the performance of this work¢ I agree to perform all work pursuant to rules governing the described construction.
Signature y~
, Agent/Owner
Address 5060 KENWOOD CT OSHKOSH WI 54904 -0 Telephone Number
231-3744
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
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
INDUSTRIAL
VENT
CON. BURNER
MANUFACTURER
CIRCLE ~L ~PLI~LE
USE ~TE~RY ~ F~IL~ DUPLEX ~TI-F~ILY CO~ERCI~
F~L
~ OIL ELECTRIC SO~ SOLID
SYST~ ~~ REP~CE OTHER
TYPE
IS ~I~ BEIN~ LI~D ~ ~ LINER SIZE
Note: All chi~eys shall be sized per the B~'s being vented.
~I~Y ~PE
H~T LOSS AS APPRO~D EXISTING · NOT APPLI~LE
B~ ~TE A~_PER~
V~ (Including l~or ~d
~lec~rical installation of new/replacemen~ e~ipmen~ shall be done by licensed
con~rac~ors.
OTHER
VARIABLE OTHER VALUE
o ,,,-,,',&7-o/ %7-
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
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ............ 2 .................................................................................................... $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.
OJ'HK~]SH
ON THE WATER
City of Oshkosh
Division of Inspection Services
215 Church Aveaue
PO Box 1130
Oshkosh W! $4902-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(I) (We)
(Electrical Contractor Name)
(Address) (City)
have been contracted to perform electric installation work for
at the following address:
(State) (Zip Code)
{Name 6fparty contracted to)
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
'" ~ o~
The value of this work is 5; ,,,2 ~.,ff~ .
I hereby verify this work will be performed by an employee of this company and furthe3 verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
Signamre of Company Officer)
(Print Name of Officer)
(Date)