HomeMy WebLinkAbout0099504-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 34 W 10TH AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
ADONIS HEATING AND COOLING
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner DENNIS P PANICH
Category 500- Residential-Heating & Ventilating
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
99504
01/20/2003
Other
Vent J
Use/Nature DUPLEX/Replace lower apartment furnace - 60m btu. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$38.00
Date 01/20/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W2707 County Rd H Pine River WI 54965 -0
Telephone Number
685-0458
OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature
of Work
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No
99504
34 W 10TH AVE
ADONIS HEATING AND COOLING
Owner DENNIS P PANICH
~J Forced Air t I
~--Electric I [~ Hot Water
Category 500 - Residential-Heating & Ventilating
~ Chimney A ~.~ Chimney B ~t Direct Vent
~ As Approved ~ Existing
[~ Gas ] L~ oil I [] Electric 1 L~ Solar
[] New I [] Replace I
b---J Radiant ~ Steam I L--J NC
~ Suppl. I U Con. Burner
¢.~ Not Applicable J
O Not Applicable J Value
O Other j Value
~ As Per Plan (.~ Variable
Create Date 01/20/2003
Plan
[] Other I
b-J vent
DUPLEX/Replace lower apartment furnace - 60m btu. *EIV form from Seckar Electric.
F~ees: Valuation
Issued By: ~ [(~
$2,200.00 Plan Approval $0.00
Permit Fee Paid
[] Permit Voided j
In the perfo, rrr~nce of thi~, I agr e~to,~erform a~, ~.Qrk purs~lant ~3-rufes governing
Signature ~./~.~ ~'~~r~
Address W2707 Coun~ Rd H Pine River
the described construction.
Date
WI 54965 -0 Telephone Number
$38.00
Date 01/20/2003
685-0458
~ity of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON 'EH~ WATER
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 Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds,, check here
if you want this processed through your account ~
JOB ADDRESS
OWNER ~9 ~t~
CONTRACTOR
c__: oc_) z ~' ,,dO.___
CHECK [] ALL APPLICABLE
USE CATEGORY
mSingle Family e,[~uplex
IZIMulti-Family
[]Rental []Commercial []Industrial
FUEL ,,J~as F1Electric FISolid SYSTEM rlNew ,,l~lace
[] Oil [] Solar [] Other
TYPE
,~orced Air []Radiant •Steam FIA/C nVent []Electric []Hot Water IZISuppl.
IS CHIMNEY BEING LINED .~, o []Yes - LINER SIZE ~- & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented. ~ V' C/t--) ~-
CHIMNEY TYPE []Chimney A nChimney B ~rect Vent []Other
HEAT LOSS []As Approved []Exi sting ' •Not Applicable
BTU RATE nAs Per Plan •Variable []Other Value
[]Con. Burner
DESCRIPTION OF ALL WORK BEING DONE f~f£~cd~ LO~ ~.f /ff/g/z?~$a
(:oe-p~c~_ ~ - gcP,,~ E~ 9'07.6'5o ~/rc r~,c,~ ~
VALUE (Including labor and all materials including light fixtures) $ ~ ~ ~ ~) ~
ELECTRICAL CONTRACTOR ~ ~_e ~ l~ f Lc g ~ C 7~1 C
[] 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
FAX NO. : Aug. 11 2002 03:00AM P1
ElectFic lastllLtfion Verification
Th~ naturm of th~ work, coz~sis~ of: (~ One or D~ ~= ~= of Wink)