HomeMy WebLinkAbout0099820-HVAC (chimney)OSHKOSH
ON THE WATER
932 WINNEBAGO AVE
BLACK CAT CHIMNEY SERVICE & CON(:
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner RYAN L PITZEN
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
99820
02/13/2003
Other
Vent J
180,000 btu
Use/Nature SFR/Line chimney for furnace & water heater (chimney is unlined).
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
932 WINNEBAGO AVE
BLACK CAT CHIMNEY SERVICE & CON~
Job Address
Contractor
Fuel
System
b~ Gas I
~]New
Forced Air J
Electric
Chimney Type ~_~ Chimney A
Heat Loss ~(~ As Approved
BTU Rate ~) As Per Plan
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner RYAN L PITZEN
LJ oi~
~_j Radiant
b~ Hot Water
Chimney B
~,~ Existing
~ Variable
Category
500 - Residential-Heating & Ventilating
[] Electric 1 [] Solar
[] Replace I
L-J steam j ~ NC
[] Suppl. 1 [] Con. Burner
Direct Vent ~,~ Not Applicable I
O Not Applicable I Value
O Other I Value
No 99820
Create Date 02/13/2003
Plan
[] Solid
bJ vent
180,000 btu
Use/Nature
of Work
IFR/
Line chimney for furnace & water heater (chimney is unlined).
Fees: Valuation
Issued By: F
$375.00 Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 0~13/2003
[] Permit Voided J
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Agent/Owner
Date
Address PO BOX 1946 OSHKOSH WI 54903 -1946 Telephone Number (920) 279-0197
P,O. BOX 1130
O~hkosh, WX 54903-1130
Fax (920) 236.5084
Phone (920) 23S-S048
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will nos be processed.
CXRCL~ ALL APPtZCABLg
USB CATEGORY S~NGL~ ~F~i~~Ly DUPLEX MULTI-FAMILY
FU~L ~ OIL ELECTRIC SOLAR
fYfTEM NEW REP~C~ ~
EL~Ri C H~ WATER SUPPL..
oh,:Lmneye ohs11 be sized per =he BTU's being yen=ed,
CHIMNEY A CHIMNEY B
AS APPROVED EXISTING
AS PIeR PLAN VARIABLg
Note: All
CiLZMNBY ~l
mT LOff
COMMERCIAL
SOLID
A/C
INDUSTRIAL
CON. BURNER
lie=Crt=al tn. tall&=Ion o! ne'w/replscem~nt equipment shall be done b7 licensed
contractors,
~lUati°P Fee__~s
$0 to $1,000.00._____ ......................................... $20.00
$1,O00.01 to $10,000.00 .............. , .......................... $20.00 for first
$1,000.00 plus $1.$0 per $100.00 value:ion or part thereof
$10,000.01 tO $25,000.00 ........ ---------. .
.......................... $155.00 for ftrs~
$10,000.00 plus $1.00 Per $100.00 valuation or part thereof
Over 825,000.00 ............................... _..-- .... .-.----.--.---$30$.00 Plus SO.SO
per $100.00 value=ion or part :hereof
· Submit paymen~ with application. Failure to pay within 30 da~s will resul2 in
fees bein~ doubled or $100.00 plus =he normal permi2 fee, which ever is
~rea=er.