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HomeMy WebLinkAbout0099200-HVACOSHKOSH ON THE WATER Job Address Contractor Fuel System Chimney Type Heat Loss BTU Rate CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD No 99200 3191 REBECCA RUN CONDON TOTAL COMFORT L~J Gas I [] New Forced Air ~d Electdc [ Chimney A As Approved As Per Plan Owner THOMAS N RUSCH Category 500 - Residential-Heating & Ventilating ~ Oil ] ~ Electric I L] Solar I [] Replace I b---J Radiant I L] Steam I L~ Hot Water t ]~ Suppl. Chimney B ~ Dire~ Vent ~ Not Appli~ble ~ Existing ~ Not Appli~ble ~ Variable ~ Other Create Date 11/21/2002 Plan I ~'Solid I [] Other I LJ NC Con. Burner Value Value Vent j 80m btu Use/Nature of Work INSFR/Install gas furnace, 3 T a/c system and duct system. Fees: Valuation $6,400.00 Plan Approval $0.00 Permit Fee Paid Issued By: $101.00 Date 12/26/2002 [] Permit VoidedI In the performance of this work, I agree to perform ail work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 11 BLACKBURN ST RIPON WI 54971 - 184 Telephone Number (920) 748-5050 City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 ?©/HKO/H HVAC PERMIT APPLICATtONqTy OF All info~ation after bold categories must be prov,ded.' ~Op~ffE~~ 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 you want this processed through your account [-] DATE CHECK [] ALL APPLICABLE )~SE CATEGORY ingle Family U1Duplex mMulti-Family ElRental U1Commercial Fllndustrial FUEL ~asil mElectric nSolid [3Solar SYSTEM /~w [3Other E]Replace F1Hot Water UISupPl. mCon. Burner & MANUFACTURER TYPE ]~Forced Air mRadiant U1Steam F1A/C [3Vent U1Electric IS CHIMNEY BEING LINED j~No [-IYes - LINER SIZE Note: All chimneys shall be sized p6r the BTU'"s being vented. }[i3'~Chimney B mExisting F1Variable Ehirect Vent mOther t Applicable_ .-~ er Value fig tLc-~ ~r'/'-~./~ ,/ CHIMNEY TYPE HEAT LOSS BTU RATE [3Chimney A [3As Approved [3As Per Plan DESCRIPTION OF ALL WORK BEING DONE VALUE (Including labor and all materials including light fixtures) ELECTRICAL C O NTRA CT OR--_4 ~-~tt.~o [] 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