HomeMy WebLinkAbout0099594-HVACOSHKOSH
ON THE WATER
.lob Address 3660 JACKSON ST
Contractor PALISADES SHEET METAL
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner BERGSTROM OLDS-CADI GMC TK-NISS If
Category 512- Ind. & Comm-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
No 99594
Chimney Type I~ ChimneyA O Chimney B
Heat Loss IO As Approved ~ Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Create Date 01/06/2003
Plan G7-01-0103
Not Applicable
Other
Solar J L~ Solid
~J Other
A/C I L~ vent
Con. Burner I
Not Applicable
Value
Value
Use/Nature COMM/HVAC for Body shop conversion/remodel.
of Work
Fees: Valuation
Issued By:
$54,500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided
$453.00
Date 01/27/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1475 RACINE ROAD MENASHA WI 54952 -0
Telephone Number
(920) 729-1282
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh~ WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
JOB ADDRESS
OWNER
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed. ~
3660 Jackson Dr
Bergstrom 01ds Cad Gmc.
DATE i/16/03
SOLID
A/c
VENT
CON. BURNER
CONTRACTOR Pal isades Sheet Metal
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY
FUEL ~ OIL
ELECTRIC
SOLAR
SYSTEM NEW ~A~ OTHER
FORCED AIR JRAD_~ STEAM
TYPE
ELECTRIC HOT WATER SUPPL.
INDUSTRIAL
IS CHIMNEY BEING LINED LINER SIZE
J~-~Wote: All chimneys shall be sized per the BTU's being vented.
~J~NUFACTURER
CHIHNEY TYPE CHIMNEY A
HEAT LOSS ~
NATURE OF WORK:
EXISTING
VARIABLE
VALUE (Including labor and materials)
ELE C.TI~ I C~J-.
DIRECT VENT OTHER
NOT APPLICABLE
OTHER V~UE
~nse
Electrical installation of new/replacement equipment shall be done by lic~
contractors.
Valuation Fees
$o to $1,ooo.oo ...................................................................................................................................
$1,000.01 to $10,000.00 ............................................................................................................ $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 ........................................................................................................... $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
~.-0ver $25,000.00 .................................................................................................................................... $305.00 plus $0.50
per $100.00 valuation or part thereof
· Submit paymen~ with application. Failure to pay within 30 days will resUlt in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.