HomeMy WebLinkAbout0099168 HOSHKOSH
ON THE WATER
573 MOUNT VERNON ST
GRANT SCHULTZ HEATING & COOLINE-
Job Address
Contractor
Fuel
System
CITY OF,,0SHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner HAROLD/MARTHALY SHULL
I~J Gas I LI Oil
[] New J
~ Forced Air j ~] Radiant
LJ Electric I
Category 500- Residential-Heating & Ventilating
L] Electric
[~_ Replace
Steam
Hot Water I ~1 Suppl.
Chimney Type ~ Chimney A {,2 Chimney B {.) Direct Vent
Heat Loss ~ As Approved ~ Existing I~I Not Applicable
BTU Rate ~ As Per Plan (~ Variable ~l Other
bJ solar
L~ Nc
~J Con. Burner
Not Applicable
I Value
I Value
No 99168
Create Date 12/23/2002
Plan
I ~J Solid I
E~ Other !
Vent
USe/Nature SFR/Replace furnace * ElY from Beez Electric attached.
of Work
Fees: Valuation
Issued By: ~
$2,150.00 Plan Approval $0.00 Permit Fee Paid
Date
[] Permit Voided j
In the performance p.f ~'~Work, I ~gre~tCerfqrm all work pursuant to rules governing the described construction.
Signature C~~//~L~ d~~'--~''
~ Agent/Owner
Address 1411 S MAIN ST Oshkosh WI 54902 - 0 Telephone Number
$38.00
12/23/2002
Date
(920) 216-1616
ivision of Inspection Services
O. ~ox 1130
;hkosh, WI 54903-1130
~one (920) 23~-5050
~x (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HI(OfH
ON THE WATER
Appiication(s) and fee(s) can be brought to City Hall, Room 205 or marled to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled orS100.00 plus the
normal permit fee, which ever is greater.
OR
you are a contractor participating in }he Permit fee Account System and have adequatq, funds, check here
you want this processed through your account [']
DATE
HECK [] ALL APPLICABLE
5E CATEGORY
l-IDuplex
EIMulti-Family FIRental
V1Commercial
Vllndustrial
3-EL ~as r-iElectric [3Solid SYSTEM DNew
nOil DSolar ElOther
,~[Replace
krPE
"/--Forced Air FIRadiant [3Steam nA/C nVent [3Electric
CHIMNEY BEING LINED ~No F1Yes - LINER SIZE
~te: All chimneys shall be sized per the BTU's being vented.
[IIMNEY TYPE nChimey A F1Chimney B ~Direct Vent FIOther
EAT LOSS F1As Approved [3Existing [3Not Applicable
FU RATE F1As Per Plan EIVariable EIOther Value/~
~SCRIPTION OF ALL WORK BEING DONE ~/~'e ~/7~
EIHot Water ElSuppl. [3Con. Burner
& MANUFAC~R
~LILFE (Including labor and all materials including light fixtures) $ 2/~'~-~'
~ECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
12/11/2882 21:55
9282317255
BEEZ ELECTRIC
PAGE
81
Electric Installation Verification
(I) (We) Beez Electric, Inc ....
52___2L..~.j2.~.2 ~ _____ 54902
have been contracted to perform electric installation work for Ora_ut Schultz_H_eating & Cooling,
at the following address: 573 Mt. Vernon..
The nature of the work consists of: (Ch~,ck,One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/d COndenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require a separate permit.
Re, connection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $1 SOD_C}_
I hereby Verify this work will be performed by an employee of'this company and Further verify the
rcconnection / installation will be done in compliance with manufacturer and Electric code
retirements.
.Ga. ry Bi~sinv-.e_~
12/11/02
($~gaatur. of CO]iap~y Officer)