HomeMy WebLinkAbout0099473-HVACOSHKOSH
ON THE WATER
.lob Address 494WINDINGBROOK DR
Contractor BREWER HEATING
Fuel ~J Gas ~
System ~J New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner JAMES MATHUSEK
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99473
09~06~2002
Other
Vent J
105m btu
Use/Nature NSFR/ Install HVAC system for new home.
of Work
Fees: Valuation
Issued By:
$5,400.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$86.00
Date 01/16/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address N8804 N DOUGLAS STREET RIPON WI 54971 -0
Telephone Number
(920)748-6494
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
· 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 ~s greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account ["]
DATE
CONTRACTOR ,~IJ0ctJ~ [4 ~r~-']NG, IN ( -
CHECK [] ALL APPLICABLE
USE CATEGORY
~[Single Family r'lDuplex l-lMulti-Family ~o~,~o ~(~al ._~'~ mlndustrial
[] Oil Fl Solar %~XS\'E30t. her
TYPE
~Forced Air r-lRadiant F1Steam ~'A/C F1Vent []Electric •Hot Water []Suppl.[]Con. Burner
IS CHIMNEY BEING LINED []No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be'_mg vented.
& MANUFACTURER
CHIMNEY TYPE F1Chimney A []Chimney B [~Direct Vent []Other
HEAT LOSS F1As Approved I-1Existing~ F1Not Applicable
BTU RATE mAs Per Plan F1Variable []Other Value /~'-~% a~
DESCRIPTION OF ALL WORK BEING DONE /-/
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02