HomeMy WebLinkAbout0085812-HVAC
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G
OSHKOSH
ON THE WATER
Job Address 3200 MOCKINGBIRD WAY
CITY OF OSHKOSH
No
85812
HVAC PERMIT -APPLICATION AND RECORD
Owner GILBERT & CYNTHIA FRANK
Create Date 03/26/2001
Contractor BREWER HEATING
Fuel ~j Gas I Oil
System ~ New
~ Forced Air U Radiant
I I Electric U Hot Water
Chimney Type U Chimney A C) Chimney B
Heat Loss [) As Approved () Existing
BTU Rate [) As Per Plan () Variable
Category 502 - Residential-Both
U Electric
D Replace
U Steam
I I Suppl.
e Direct Vent
Plan
L J Solar U Solid
D Other
~ NC U Vent
U Con. Burner
C) Not Applicable
C) Not Applicable
e Other
Use/Nature NSFR /INSTALL NEW FURNACE AND NC FOR NEW HOME
of Work
Value
Value 60,000
Fees: Valuation ( $4,600.00
eJ(l)S
Plan Approval
$0.00
Permit Fee Paid
$74.00
Issued By:
Date 05/08/2001
D Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature S~
Date
Agent/Owner
Address
N8804 N DOUGLAS STREET
RIPON
WI 54971 - 0
Telephone Number (920)748-6494
"".........- -::: 1;- ~
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ON 1111 WA'i[ k
Division of Inspection Services
215 Church Avenue
i. O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE S- '1-0 I
JOB ADDRESS 3~oo Y1)oC.l<Jt\lG 1)1 J\ 0
OWNER ,0 m ~ f\P-N K
CONTRACTOR e,R~W€t\ \1 ffiT\\\l G
\\ ~ .C}J
CIRCLE ALL APPLICABLE
-----...-.-
USE CATEGORY~~~~~~~AY4I~
FUEL ~ OIL
SYSTEM _..~~~
TYPE <:~~~~~~_~.~~~__)
DUPLEX
MULTI-FAMILY
COMMERCIAL
INDUSTRIAL
ELECTRIC
SOLAR
SOLID
REPLACE
OTHER
RADIANT
STEAM
~
VENT
ELECTRIC
HOT WATER
SUPPL.
CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
MANUFACTURER
CHIMNEY TYPE
CHIMNEY A
CHIMNEY B
cTffRECT \tEN.V
---..._.;~-,,~~~,~_.~.~--.,._~.~.-.-..-
OTHER
HEAT LOSS
AS APPROVED
EXISTING
NOT APPLICABLE
BTU RATE
AS PER PLAN
VARIABLE
OTHER VALUE 6~~sIO
NATURE OF WORK:
VALUE (Including labor and materials) $
7(6c-Jc? ~
1
ELECTRICAL CONTRACTOR
Electrical installation of
contractors.
"
,
new/replacement equipment shall be done by licensed
Valuation
Fees
$ 0 to $1, 000 . 0 0 .m.................................................................................._.........._...................................$ 2 0 . 00
$1, 000 . alto $10, 000 . 0 0...................................................................._.........................................$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
Over $ 25 , 000 . 0 0 .......................................................................................,...............................................$ 305 . 00 p I us $ 0 . 50
per $100.00 valuation or part thereof
· Submit payment 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.