HomeMy WebLinkAbout0099149-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
JobAddress 1055 HERITAGETR
Contractor DRUCK'S PLBG & HTG & CLG
Fuel t~ Gas I ~J Oil
System [] New I
[~ Forced Air I ~ Radiant
~j Electric I [~ Hot Water
Chimney Type ~,~ Chimney A O Chimney B
Heat Loss ~ As Approved ~I Existing
BTU Rate ~ As Per Plan ~t Variable
CITY OF OSHKOSH
HVAC PERMIT- APPLICATION AND RECORD
Owner CARL F BERSCH
Category 502 - Residential-Both
[~ Electric I ~ Solar
[] Replace I
[~ Steam I ~J NC
U Suppl. t U Con. Burner
~ Direct Vent ~.~ Not Applicable I
~ Not Applicable I Value
~ Other I Value
No 99149
Create Date 12/19/2002
Plan
U Solid
[] Other
J L--J vent I
60m
Use/Nature SFPJ Replace furnace & a/c. *EIV form from Solar Electric.
of Work
Fees: Valuation $5,495.00 Plan Approval
Issued By:
$0.00 Permit Fee Paid
[] Permit Voided I
$87.50
Date 12/19/2002
In the pedormance ofthiswork, I agree to perform allwork pursuantto rules governing the describedconstrucfion.
Signature Date
Agent/Owner
Address 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0
Telephone Number
(920) 426-2654
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
Ail fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
RECEIVED
DEC '1 RO0
DEP RT ENT OF
COMI?JUN TY DEVELOPMENT
CIRCLE ALLAPPLICABLE
USE CATEgORy ~F~ I L~Y DUPLEX
FUEL ~ OIL ELECTRIC
SYSTEM NEW ~
TYPE ~ RADIANT
'ELECTRIC HOT WATER
MULTI-F~MILY COMMERCIAL
SOLAR SOLID
OTHER
STEAM
SUPPL.
IS CHIMNEY BEINO LINED //~ LINER SIZE
NOte: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A ~
HEAT LOSS AS APPROVED ~
BTU RATE AS PER PLAN ~
INDUSTRIAL
VENT
CON. BURNER
MANUFACTURER
DIRECT VENT OTHER
NOT APPLICABLE
OTHERVALUE~.~O
.VALUE (Including labor and materials) $,ua,--~/F~-
ELECTRICAL CONTRACTOR ,f/~W/~/~W~''/crr/°/'~'/c
Electrical installation of new/replacement equipment shall be done by licensed
contractors. .~.
Valuation Fees
$0 tO $1,000.00 ............................................................................................................ $20.00
$1,000.01 to $10,000.00 ............ " ......................................................................... $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 .......... "..i ................................................................................. $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ...................................................................................................... , .......... $305.00 plus $0.50
per $100.00 valuation or part thereof
Submit payment with application. Failure to pay within 30 days will result in
fees beingldoubled or $100.00 plus the normal permit fee, which ever'is
greater.
Electric Installation Vertflcatlon
~ (we)
(A~,~s) (oity) (sm,=) (z¥
/N~nc ofl~rt~ con=ac~ to)
Thc n~ture of~ work c~nsis~ of: (Che~k One or
The valuta orris Work is $ '~
I hcrcby verify ~ work will b= performed by an cmploy~ oflhis compawy and further veri~
recennect/on I imlallat~u will be/one tn compli~ wiJt ~ iud l/l~'~ric ~