HomeMy WebLinkAbout0098679-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1300 WHEATFIELD WAY
BREWER HEATING
LJ Gas
[] New
Forced Air J
Electric I
Owner PETER J/HATTIE BECICH REV TRUST
Category
500 - Residential-Heating & Ventilating
Oil I ~ Electric
[] Replace
Radiant I L-J Steam
HotWater I LI Suppl.
Solar
I--J NC
LJ Con. Burner I
Chimney Type ~ ChimneyA (-.2 ChimneyB (.~ DirectVent ~1~ Not Applicable I
Heat Loss ~ As Approved ~ Existing ~I Not Applicable I Value
BTU Rate ~.~ As Per Plan ~ Variable ~1 Other I Value
No 98679
Create Date 11/08/2002
Plan
[~ Solid
[] Other
Vent j
Use/Nature ~FR/
of Work
LATE PERMIT/Add supply ducts to addition.
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
[] Permit Voided
$120.00
Date 11/18/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
RIPON WI 54971 -0 Telephone Number
Address N8804 N DOUGLAS STREET (920)748-6494
RECEIVED
Division of Inspection Services
P.O. Box 1130
Oshkosh,
WI
HVAC PERMIT APPLICATION
AIl info~ation aft~ bold cat~o~i~s must b~ provided.
· Application(s) and fee(s) can be b~ou85t to City ~a]], ~oom 205 o~ marled to ~spcctio~iccs, ~O ~ox 1128,
Oshkosh ~I 54903-1 ]28. Commenoin~ ~o~k witSout pe~it(s) ~i]] ~esu]t in fees bein~ doub]ed o~ $100.00 plus the
OR
JOB ~D~SS {300
CItECK [] ALL APPLICABLE
USE CATEGORY
~Single FamilY
•Duplex •Multi-Family ElR4ntal DCommercial
FUEL •Gas
•Oil
[]Electric [] Solid SYSTEM [New
[] Solar •Other
•Replace
•Vent •Electric •Hot Water •Suppl. F1Con. Burner
IS CI-IIMNEY BEING LINED []No []Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be'.mg vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[] Chimney A
FIAs Approved
FIAs Per Plan
•Chimney B
•Existing~
[]Variable
[]Direct Vent
F1Not Applicable
[]Other Value
[]Other
DESCRIPTION OF ALL WORK BEING DONE jOrdd
VALUE (InclUding labOr and all materials inclUding light fixitires) $ --~00 o.
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
3/02