HomeMy WebLinkAbout0099614-HVAC (furance)OSHKOSH
ON THE WATER
.lob Address 826 BISMARCK AVE
Contractor RYF HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner KEVIN L/ELAINE SCHOUTEN
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
O Existing
O Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99614
01/29/2003
Other
Vent J
60m
Use/Nature SFR/Install new furnace.
of Work
Fees: Valuation
Issued By:
$2,650.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$44.75
Date 01/29/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 240 MAIN ST PO BOX 450 WINNECONNE WI 54986 -450 Telephone Number
582-4451
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.
Q/'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 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 _t..hro_~f~h. your_ account
CONTRACTOR lieu
DATE ~/- a,~ ~ - OX
EECEIVED
CIi EE KEI ALL'APPLIcABLE ....................................................... clAN 2 9 200J ...................
USE CAT~GO~Y DEP^RT~E!~T nr
~Single Fmily DDuplex DMulti-Fmily DRental ~~~ DEV~dustfial
FUEL IS[Gas F1Electric VISolid SYSTEM V1New t~Replace
F1Oil VISolar .... [3Other
TYPE
~l~Forced Air mRadiant VISteam F1A/C FIVent FIElectric
IS CHIMNEY BEING LINED V1No I~Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
[2]Hot Water [3Suppl. I-1Con. Burner
& MANUFACTURER/~-/~..~ ~,~/_..~, ~.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[3Chimney A
I-lAs Approved
[3As Per Plan
VlChimney B
_~xisting
ariable
JSlDirect Vent V1Other
VINot Applicable
,EIOther Value ~'~ o o~
VALUE (Including lab°r and allmaterials including light fixtures) $
ELECTRICAL CONTRACTOR 5e..c-/~..a.,' ~/t-_c~ i
~ [] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a s~parate Electrical Permit is required.
FROM :
FAX NO.
Rug. 19 i~ 84:01PM P2
Electric Imtallttion Yertficmtion
TI~ nstarl oft~ work consis.,s of: (C~k O~ o~ D~ ~c Na~e of W~k)
(D~e)