HomeMy WebLinkAbout0098831-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address 1402 W MURDOCKAVE
Contractor SAMMONS PLUMBING OSHKOSH INC
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Gas I I~ Oi~
Forced Air J ~_J Radiant
Electric 1 [~J Hot Water
Chimney Type ~ ChimneyA ~ Chimney B
Heat Loss ~ As Approved ~.~ Existing
BTU Rate ~ As Per Plan ~_~ Variable
Owner EDWIN CELICHOWSKI
Category 500 - Residential-Heating & Ventilating
~- Electric 1
[] Replace
~_J Steam I
Id Suppl. I
Direct Vent
[] Solar
No 98831
Create Date 11/27/2002
Plan
t [] Solid
[] Other
~ NC
[] Con. Bumer I
Not Applicable
Not Applicable
Other
Value
Value
Vent
Use/Nature
of Work
IFPJ
Replacel boiler. *EIV form from Slim's Electric.
Fees: Valuation
Issued By:
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit VoidedI
$35.00
Date 11/27/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 522 W MURDOCKAVE OSHKOSH WI 54901 -0 Telephone NUmber
920-231-9880
. FROI~: SAMMONS PLUMB] NG
~" ' ,,Or ;.q~ O~
FAX NO. : 9202318485 Now.
Oshkosh InspeCtions 9P.O
~6 2002 OJ: ~PM
~3C -~084
P2
HVAC PERMIT APPLICATION
All inforrrlalion a!'rcr boJd categories taus! bc provi~d,
Incomplele apphcai~on~ wlil aa; ~ processed.
· App{icatiOn0) and fee(s) can be bro'..ight u, C,:y Hall. R,.,..,m 31')~ or mailed to ~s~c~io~ lemccs, PO Box I
Oshkosh WI 54903-[128. Co~cnc:ng work without pcrmiffs)'wW rc~uh in ~ees ~in~ doubled or S I00.0(~
' --'a ''-I,~,,~ ~ ................... --':' ~fr~'}et
JOB.akDDRE$S 1402 W. ~urdock Avenue
owrv£a .............. _._r.~_.. c_~ .~ i_.Ch o ws ~, i
CON'i'RA(;~OR__ Sa-nlm-ohs Pl Umblng
DAT~ 11126/02
CHECK 6] ALL APPLICABLE
USE CATEGORY
FUEL
TVPF.
~I"orcecl Air [2Radiant []Ste.~m ~^/C' FgVe,, ~l~:t~
i$ CHTMN'~ y
Nolc: Ali :hi~eys shrill ~ ~ed p~ ~e LeVi's being vented. ' .
ORental F'Commcrcial ~Indusma?
SYSTEM ONew 4ClRcplace
OOther
~]Hul Water ~$upp!. ricoh, B,.wner
CHIMNF~y TIqPE rqCh.:'zv~ey A DChil,mcy B DD;r~:I Vcn~ ~Oth~
HEAT LOSS ~A~ A~rovcd ~Exi~tL~g ~Not A~lJcablc
B~; ~TE ~As P~r Plan ~Vanable ~O~hcr ~alue
DE$CI~PI'ION OI;' ALL WORK 8EINC DONE .......... ~.e_pl_a_ce hod 1 er
VAJ.UF. (Including labor ~od alJ malerials i,,clud~n$ light ~nures) ~ 2000. O0
EI, EC'T~CAL CONT~C'I'OR SZ ~ , s E1 ect z~ c .rnc .
- ~or appbcabJe prqlect~, an ~lec~lo blstallat:on Vc~l!cation fo~ ~i~ed by ~e Elec~ol Corl:ac~o~. ,r;u~: he
anaehed. If nol at~chcd or not applicaOl~, a separa~ Elec~ica] P~t ~$ requital.
Iqltll IBm
Electric Installnflon VerificatioB
SLiM'$ ELECTRIC INC.
2608 Oakwood Ci. rc._!~ ...... Oshkosh
(Addr==) (C~)
the followins 8ddrees:
WI 54904
.... (s.m) "-(z~c~)
Sam=mon's
1402 W. Murdock St. _,
125.00
David A. Younclwirth_
(Print 3,,,"e ot
09/03/02
£d Nd£0:£0 ~00~ 9~ '~ON SBt~T£gO~G: 'ON XUJ' ' gNISNRqd ShlONN~$: NO~J
~ FROM~:SAMMONS PLUMBING FAX NO. :9202318485 Nov. 2G 2002 03:02PM P1
522 W. Murdock Avenue
920-231-9880
Fax: 920-231-8485
· re: Cily of Oshkosh I:mm: Mike Sammons
ATTN: Plumbing Inspector p~e~; 4
Plmne: 920-231-9880 I~e: 11/26/02
Re=, Plumbing permit CI3:
[] Urgertt X For Review [] Please Gommmtt [] Please Rel~lY rl Please Iteeyole
· Cemme,tts; Please process the following plumbing permit,
Please pay from our account.