HomeMy WebLinkAbout0098523-HVAC (furnace) CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No
98523
OSHKOSH
ON THE WATER
Job Address 1890 S WESTHAVEN DR Owner MICHAEL J/THERE BALKE JR Create Date
Contractor CUSTOM HEATING & COOLING Category 502- Residential-Both ' Plan
Fuel I~ Gas t ~ Oil I [~ Electric I ~ Solar
System [] New I [] Replace I [] Other
~.J Forced Air J L-J Radiant ] ~_] Steam ] L~J A/C
~ Electdc I [~ Hot Water I ~ Suppl. I [~ Con. Burner
Chimney Type ~ Chimney A (.~ Chimney B ~I Direct Vent (.~ Not Applicable
Heat Loss ~ As Approved (_~ Existing O Not Applicable I Value
BTU Rate ~ As Per Plan ~ Variable O Other I Value
11/08/2002
Use/Nature SFR/Replace 80m btu furnace & 2.5 ton NC. *An EIV form was not submiited, so a separate electrical permit is required.
of Work
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
[] Permit Voided I
$65.00
Date 11/08/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0 Telephone Number
(920)235-7263
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
NOV 0 8 200~
O/HKO/H
AP ' DEPARTMENT OF o. THE w^T,.
HVAC PERMIT ~1~t~'~ ~EVELO PM ENT
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 vou are a contractor participating in' the Permit fee Account System and have adequate~ funds, check here
ifyouwantthisprocessedthroughvouraccount r-]DATE
JOB ADDRESS
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
l[3S~gle Family r3Duplex
F1Multi-Family
[2]Rental r-lCommercial mlndustrial
FUEL l!SGras F1Electric [2Solid SYSTEM nNew ~eplace
FIOil [] Solar F1Other
l~],F-~ced Air FIRadiant [3Steam EVent [3Electric F1Hot Water mSuppl. F1Con. Burner
IS CHIMNEY BEING LINED ~o []Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[]Chimney A
[3As Approved
[]As Per Plan
[]Chimney B
[]Existing
FIVariable
DESCRIPTION OF ALL WORK BEING DONE
~rect Vent [3Other
V1Not Applicable
[]Other Value
VALUE (Including labor and all ~tT~nclud~g light fixtures) $ Y~
ELECTRICAL CONTRACTO]?,"~/-- ~ OR [] Electric Installation Verification form
attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
3/02