HomeMy WebLinkAbout2002-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
2585 VILLAGE LN
CUSTOM HEATING & COOLING
Gas I
[] New
L~ Forced Air t
Electric j
~ Chimney A
~.~ As Approved
~.~ As Per Plan
Owner OTTO J / KAREN L SEIFERT
Category 500 - Residential-Heating & Ventilating
~ Oil J ~ Electric I M Solar
[] Replace I
L~ Radiant I b~ Steam J La NC I
I I Hot Water J ~J Suppl. J LJ Con. Burner J
Chimney B {~ Direct Vent ~ Not AppJi~ble I
~ Not Appli~ble j
~ Other I
(~) Existing
(.~ Variable
Value
Value
No
Create Date
Plan
½ Solid
[] Other
Vent
11/13/2002
Use/Nature
of Work
Iondo/Add heat ducts to finished basement.
Fees: Valuation
Issued By:
$600.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided J
$20.00
Date 12/05/2002
In the performance of this work, I agree to perform all work pumuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0 Telephone Number
(920)235-7263
CiW of Oshkosh
Division of Inspection Sem-'ices
P,O. Box 1130
OsF&osh, WI 54903- I 130
Phone (920) 236-5050
Fax (920) 236-5054
All infomfion a~e~. bold. categories, mu~t ~ ~0~ ' Inco~lete apphcauons ~il not be processed.
Application(s) and fee(s) can be brought to City, Hail. Room 205 or maded to Inspection Services, PO Box 1128,
Oshkosh WI '54903-1128. Commencing work without permit(s) wil! result in fees being doubled or
normal permit fee, which ever is greater,
OR
[f_y_ou ar_ _e__a contractor partici~ating in the Permit fee Accou~l System and haYe
CHECK ~ ALL APPLICABLE ...... ' ....... '~ ~'''' ~7',-'~,~... ~ ".'. '~%',':' - .......
USE CATEGORY
.FUEl . ~Gas . . [ZJEI~c~c ~$olid SYSTEM IZINew CIReplace
~Oil I-ISola~ CIOther
TYPE
~Foreed Air CiRadiant ~steam t-IA/C FlVent ~Electric IDHot Water l-lSuppl.12Con. Bume~
IS CllLMNEY BEING L]hXtED IZINo EYes - LINER SIZE_
Note: All cba?rmeys shall be sized per the BTU's being vented.
& MANUFAC~IIJRER
CItlMNEY TYPE UlCh~mney A E3Chimney B
HEAT LOSS FiA~'Approved CIExisting
BTU RATE FIAs Per Plan r-lVariable
~Direct Vent rlOther
F1Not Applicable
12 Other Value
¥~::(Incl-u~ing labT0rz~'fid: ~llmaterjal~;!in¢tudini~ light fixtUf~) $:;" ~:' ~' ~; "~':': :~'
ELEC~C~, CONT~CTOR~ OR LU Ele~ric l~llation Verification form aR~c~ed(Jf
~"~ ~;/'.~ :?..~ _ '~Tf~'~; ..: ::- ~ ~ . ~}.}' ~'.~- ,- :.:'~:: .... Electrical ~nstoltatio, of n~/replaceme,t ~ip~nt shatl be done by licensed
3/02