HomeMy WebLinkAbout0099071-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
2769 HAMILTON ST
BAY AREA SERVICES INC
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Gas I
[] New
Forced Air
Electric
Owner
Category
CREATIVE CUSTOM HOMES & DEVELOP
500 - Residential-Heating & Ventilating
Oil t LJ Electric I ~ Solar
[] Replace I
b-d Steam I Id NC
U Suppl. I ~--C~n. Burner
Direct Vent ~ Not Applicable I
~,~ Not Applicable J Value
O Other J Value
Radiant
Hot Water
Chimney Type ~..) Chimney A ~1~ Chimney B
Heat Loss O As Approved (.~ Existing
BTU Rate ~I As Per Plan (.~ Variable
No
99071
Create Date 12/10/2002
Plan
I [] Solid 1
[] Other I
I I__1 Vent I
1
Use/Natureof Work NSFPJ Install ductwork and furnace.
Fees: Valuation
Issued By: ~..~
$3,400.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided I
$56.00
Date 12/13/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgentJOwner
Address 1449 S BROADWAY GREEN BAY WI 54304 - 0 Telephone Number
920-435-7111
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 236-5084
DEPARTMENT OF O/HKG/H
HVAC PERMIT DEVELOPME
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
DATE
tz/ Io[0 7_
CHECK [] ALL APPLICABLE
USE CATEGORY
]~ingle Family VlDup!ex
[3Multi-Family
75Kental []Commercial VlIndustrial
FUEL ~Gas [2]Electric V1Solid SYSTEM j~/Xiew
[2Oil EtSolar [2Other
i-lReplace
TYPE '" "-
:~l.Forced Air [2Radiant l'3Steam [2A/C VIVent [2Electric [2Hot Water VISuppl. V1Con: Burn6i"
IS CHIMNEY BEING LINED }~l'No [2Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
~himney B
VlExisting
V1Var/able
& MANUFA~R
[]Other
CHIMNEY TYPE [2Chimney A
HEAT LOSS J~s Approved
BTU RATE ~As Per Plan
&
[2Direct Vent
ElNot Applicable
[2Other Value
VALUE (Including labor and all materials including light fixtures) $ .~ L( (D 0 - (DO
ELECTRICAL CONTRACTOR '~J~'~g_~, ~)sL _qocfTOR [] Electric Installat;c:. V;ri~;i6n form
Electrical installation of new~replacement equipment shall be done a',.' licensed con~racto,'s.
3/02