HomeMy WebLinkAbout0099819-HVAC (chimney liner)OSHKOSH
ON THE WATER
.lob Address 1123 MICHIGAN ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
BLACK CAT CHIMNEY SERVICE & CONC
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CHRISTOPHER J BLOECHL
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
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
99819
02/13/2003
Other
Vent J
114,000 btu
Use/Nature SFR/Line unlined chimney for furnace & water heater.
of Work
Fees: Valuation
Issued By:
$375.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 02/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number
(920) 279-0197
OSHKOSH
ON THE WATER
.lob Address 1123 MICHIGAN ST
Contractor
Fuel L~J Gas I
System [] New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
BLACK CAT CHIMNEY SERVICE & CONI
No
99819
~d Forced Air I L~ Radiant
bdElectric I [~]-Hot Water
~.~ Chimney A
~ As Approved
~ As Per Plan
Chimney Type
Heat Loss
BTU Rate
Use/Natureof Work SFR/
Chimney B
~ Existing
~.~ Variable
Owner
Category
L~ Electric
~ Replace
[~ Steam
[] Suppl.
CHRISTOPHER J BLOECHL
500 - Residential-Heating & Ventilating
[~olar
I~ AzC
[] Con. Burner
~1~ Direct Vent (.~ Not Applicable I
O Not Applicable I Value
O Other I Value
Create Date 02/13/2003
Plan
LJ Solid
[] Other
Vent J
114,000 btu
Line unlined chimney for furnace & water heater.
Fees: Valuation /
Issued By: /
$375.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$20.00
Date 02/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature '-.'~/ .,/¢_~_..(¢ ,~,¢~ £j¢~1~./~'/'
Agent/Owner
Date
Address PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number (920) 279-0197
P.O. B~ LI3:
O~osh, NZ S4~03-~30
Phone (~10) 13~-S048
HVAC PgRMIT APPLICATION
All fields/information &fCer bold catepories must: be provided.
'.n¢omple=e &pplicatiO,~l will no= be prate. Bad.
CIRCLE ALL APPLICABLE
USI ~ATIGOIY ~ DUPLEX MULTI-FAMILY
FURL ~ OIL ELECTRIC SOLAR
SYITBM NEW REPLACB ~
TYPE ~ I~J~DI~ STEAM
COMMERCIAL
SOLID
A/C V~mT
INDUSTRIAL
ELECTRIC HOT WAT~ SUPPL.
IS C~~ BIZN~ LI~'~D~.~3 LZN~ SIZE ,.S-w/
Note: All chi~meye the11~e-sized per the BTU's'being vented.
CHIMNEY A
AS APPROVED
AS PER PLAN
CHIM1T~Y B
EXISTING
VARIABLE
V'ALUB (Znolud:lng labor tud ma~erials) $ ?
I'I, EOTRZOJ~ COMTRAC'TOR
llectricel inlC&ll&tion of nlw/rlpl&ce~lnt equipment shall be done b~ licenled
con~ractorl.
Valuation Fee__~s
'$0 2o $1,000.00 ............ ::_ ...................................... 920.00
$1,000.01 to $10,000.00 .......... .___.-__._~ ..... $20.00 for fire=
$1,000.00 pluo $1.$0 per $100.00 valu&=ion or par= thereof
$10,000.01 ~o $25,000.00 ............. ~.:..... ...... : ....... --::::--- : ............$155.00 for fir82
$10,000.00 plus $1.00 per $100.00 value=ion or par= =hereof
Over $25,000.00______. ............. --.-----.--.-........... : ............. $305.00plus $0.50
~er $~00.00 v&~.M~ion or par~ the~eo~
· Submi~ paymen~ wi~h application. Failure top ay within 30 days will resul= in
feee bein~ doubled or $100.00 plul t~m noz~tl~ pex~t fee, which ever is
~reater.