HomeMy WebLinkAbout0098475-HVAC (move register)OSHKOSH
ON THE WATER
Job Address 69 LAKE ST
Contractor G & B PRODUCTS
Fuel ~- Gas
System [] New
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I [~ Hot Water
Chimney Type ~ Chimney A ~.~ Chimney B
Heat Loss ~ As Approved ~ Existing
BTU Rate ~_~ As Per Plan ~ Variable
Owner
Category
SCOTT M/MELISSA ENGEL
500 - Residential-Heating & Ventilating
M Electric I U Solar
[] Replace I
L-J Steam I I-J Nc
~ Suppl. I L~ Con. Burner
~.~ Direct Vent ~J Not Applicable j
O Not Applicable J Value
~I Other J Value
No
Create Date
Plan
J ~ Solid
[] Other
98475
09/21/2001
Vent
Use/Nature ~FPJ Move register.
of Work
Fees: Valuation ~ $191.00 ~/_.) Plan Approval
' ~ ~ ~ ~ Permit Voided J
$0.00 Permit Fee Paid
$20.00
Date 11/07/2002
In the pe~ce of this work, I a~erform all work pursuant to rules governing the described construction.
Signature ~....~.~.~ ~ Date
(~.,.~ ~.-- ~..;.-' z/ Agent/Owner
Address'~--~'26 S MAIN ST OSHKOSH WI 54902 - 6020 Telephone Number
(920) 231-5699
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
OJ"HKO/H
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating' in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account [-]
OWNER
cos c oa
X,A
CHECK [] ALL APPLICABLE
USE CATEGORY
E~ingle Family V1Duplex
V1Multi-Family
[]Rental []Commercial []Industrial
FUEL J2~as F1Electric []Solid
F1Oil FISolar
TYPE
[2gForced Air []Radiant []Steam VIA/C F1Vent
IS CHIMNEY BEING LINED [~No F1Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
F1Chimney A
~ss Approved
Per Plan
vChimey B
xisting '
ariable
SYSTEM []New FIReplace
[]Other
FIElectric [:]Hot Water F1Suppl. []Con. Burner
& MANUFACTURER
[]Direct Vent
V1Not Applicable
[3 Other Value
DESCRIPTION OF ALL WORK BEING DONE
V1Other
VALUE (Including labor and all materials including light fixtures) $ / ~ / c.,~
ELECTRICAL CONTRACTOR ~ff~e~
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02