HomeMy WebLinkAbout0099101-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
160 FARMSTEAD LN
BREWER HEATING
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No
99101
Gas
Chimney Type ~ ChimneyA
Heat Loss ~ As Approved
BTU Rate ~ As Per Plan
[] New I
L-~ Forced Air I [__j Radiant
L~ Electdc J M Hot Water
(...) Chimney B
Owner US LAND DEVELOPMENT LLC
Category 500 - Residential-Heating & Ventilating
[~ Electric I ~J Solar
[] Replace I
j__J Steam J
~]-~ppl. 1
~ll Direct Vent
0 Not Applicable I
0 Other
(_~ Existing
O Variable
Create Date 09/16/2002
Plan
I [] Solid
[] Other
I~ NC j L-J Vent
J~ Con. Burner I
Value 0
Value 60m
Use/Nature NSFR/Install HVAC system.
of Work
Fees: Valuation $3,300.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
: [] Permit Voided
$54.50
Date 12/16/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address N8804 N DOUGLAS STREET RIPON WI 54971 -0 ' Telephone Number
(920)748-6494
Division of Insl%ection Services
P.O. Box 1130
Oshkosh, WI 54903-1130 ~efip~/~?~~~/;~ ~~~ r ~H
Phone (920) 236-5050
Fax (920) 236-5084 i 8~)~/.~ ,~_~ '
HVAC PERMIT APPL CAll
info~tion after bold Categories must be provided, v~0~3~
All
Incomplete applications will not be processed. ~?
Application(s) and fee(s) can be brought to CiW Hall, Room 205 or mailed to ~spection Se~ices, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pemit(s) will result in fees being doubled or $100.00 plus the
no~al pe~it fee, which ever is ~eater.
OR
If vou are a contractor participating in the Permit fee Account Svstem and have adequate funds, check here
if you want this processed through your account ~
JOB ADDRESS
OWNER
CONTRACTOR
DATE lc~' 13 0 5,
CHECK l~l ALL APPLICABLE
USE CATEGORY
~Single Family DDuplex
ElMulti-Famity
DRental ElCommercial I-]Industrial
FUEL 't~l'Gas l-lElectric F1Solid SYSTEM DNew DReplace
DOil 1-1Solar IDOther
ElVent I-1Electric FIHot Water DSUppI.EICon. Burner
IS CHIMNEY BEING LINED DNo I-lYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's bei. ng vented.
& MANUFACTURER
CHIMNEY TYPE DChimney A FIChimney B ID. Direct Vent F1Other
HEAT LOSS I-lAs Approved l-lEx/sting l-lNot Applicable
BTU RATE I-lAs Per Plan ElVariable DOther Value ~' % ~o
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Includ~nglabor and all materials inClUding light fixtures)
ELECTRICAL CONTRACTOR
OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02