HomeMy WebLinkAbout0099005 HOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY'OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
No
99005
I~J Gas I b~ Oil
[] New ...... _~
L~J Forced Air I ~J Radiant
L~ Electric J LJ Hot Water
JO Chimney A ~I Chimney B
Owner RUSCH HOMES
1265 PHEASANT CREEK DR
BERLIN HEATING & COOLING Category 500 - Residential-Heating & Ventilating
LJ Electric ~1 Solar
[] Replace
b~ steam
~j suppl.
(.~ Direct Vent I
~_~ As Approved (.~ Existing Value
JO As Per Plan ~ Variable Value
~.~ Not Applicable
Not Applicable
Other
~1 NC
L~ Con. Burner
Create Date 10/01/2002
Plan
Ed Solid
[] Other
Vent J
Use/Nature
of Work
NSFR/ B-vent for water htr. gas piping, install new high eft. forced air furnace, pvc venting, condensate drain, duct work.
Fees: Valuation
Issued By: ~
$3,400.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided
$56.00
Date t2/10/2002
In the performance cf(this work, I agree to perform all work pursuant to rules governing the described construction.
Signature %~ \~,~ Date
~ ) Agent/Owner
Address N7545 Forest Ridge Rd BERLIN WI 54923 - 0 Telephone Number
920-361-3066
Oeo 09 02 O~:Oqa Oshkosh Inspections
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
OJ'HKO/H
ON TH[ Yd&TFR
HVAC PERMIT APPLICATION
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 Inspect/on 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
!f ¥ou are a contractor partfcipating in the Permit fee Account System and have adequate funds, .check here
if Fort want this processed through your account ~
CHECK [] ALL APPLICABLE
SinCATEGORY
gle Family []Duplex F1Multi-Family [2Rental F1Commercial Fllndustrial
FUEL alas ~Electr/c [2Solid SYSTEM ~ew FIReplace
I=]Oil [] Solar mOther
ced Air FlRadiant ZlSteam DA/C IZIVent []Electric F1Hot water F1Suppl. FlCon. Burner
IS CIrlIMN~EY BEING LINED [3No [-]Yes - LINER SIZE & MANTIFACTURER
Note: All chLmncys shall be sized per tee BTU's being vented.
CRIMNEY TYPE [2Chimney A ~Chirnney B [~/Direct Vent F1Other
HEAT LOSS [2As Approved FIExisting [3Not Applicable
BTU RATE [2As Per Plan FIVariable FlOther Value
DESCRIPTION OF ALL WORK BEING DONE /'~ -O e.~..[- tlC,;~-
VAi, UE (Including labor and all material~ including light fixtures) $ ~._~.~r ~t~.
ELECTRICAL CONTRACTOR
0 For applicable ~ojects, an Elec~c ~stallation Verification fo~, si~ed by the Elec~caI Con,actor, must be
a~ached. If not a~ached or not applicable, a s~ate Elec~cal Pemit is ~quir~.
9/02