HomeMy WebLinkAbout0088411-HVAC
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OSj;-IKOSH
ON THE WATER
Job Address 1644 HUNTERS GLEN DR
CITY OF OSHKOSH
No
88411
HVAC PERMIT -APPLICATION AND RECORD
Owner MARK T/BETHANY ANDERSEN
Create Date 07/30/2001
Contractor BREWER HEATING
Fuel U Gas I I Oil
System o New I
U Forced Air U Radiant
L J Electric U Hot Water
Chimney Type U Chimney A () Chimney B
Heat Loss () As Approved U Existing
BTU Rate () As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
I Electric
o Replace
U Steam
I I Suppl.
() Direct Vent
I Solar U Solid
o Other
U AlC U Vent
I I Con. Bumer
() Not Applicable
() Not Applicable
() Other
Value
Value
Use/Nature extend ductwork. for remodeling.
of Work
Fees: Valuation
Plan Approval
$0.00
Permit Fee Paid
$20.00
Issued By:
Date 08/17/2001
o Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
1644 HUNTERS GLEN DR
OSHKOSH
WI 54904 - 8965
Telephone Number
.~
OfHKOfH
ON llll W/\'/fl<
Division of Inspection Services
215 Church Avenue
i.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
~~q.O ,
JOB ADDRESS 1104tJ ~U~TE.Rs GLLN
OWNER Tn tt\\'S B N D ffiS(N
CONTRACTOR Bt\f.wffi N€.AT ING
CIRCLE ALL APPLICABLE
USE CATEGORY
SINGLE F.AJ.'lILY
DUPLEX
MULTI-FAMILY
COMI'1ERCIAL
INDUSTRIAL
FUEL
/;.;~
~
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~._'
~_' . .~ AIR
.. ---
ELECTRIC
OIL
ELECTRIC
ef)~rD
STEAM Alc VENT
'$ 'd-().oO
SYSTEM
REPLACE
TYPE
RAD I ANT
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
DIRECT VENT
OTHER
HEAT LOSS
AS APPROVED
EXISTING
NOT APPLICABLE
BTU RATE
AS PER PLAN
VARIABLE
OTHER VALUE
NATURE OF WORK:
VALUE (Including labor and materials) $
050-
ELECTRICAL CONTRACTOR
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
,"
.
Valuation
Fees
$ 0 to $1, 000 . 0 0.......................................................................................................................................$20 . 00
$1, 000 . 01 to $10, 000 . 0 0 ...............................................................................................................$20 . 00 for firs t
$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 plus $ 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.