HomeMy WebLinkAbout0084806-HVAC (chimney liner)
.
OSHKOSH
ON THE WATER
Job Address 908 BISMARCK AVE
CITY OF OSHKOSH
No
84806
HVAC PERMIT. APPLICATION AND RECORD
Owner STEVEN & GUDRUN HEMMINGHAUS
Create Date 03/21/2001
Contractor BLACK CAT CHIMNEY SERVICE & CONI
Fuel 1,(1 Gas UOil
System D New
U Forced Air U Radiant
I I Electric U Hot Water
Chimney Type U Chimney A () Chimney B
Heat Loss U As Approved () Existing
BTU Rate () As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
L I Solar I Solid
D Other
U NC U Vent
U Con. Burner
() Not Applicable
U Electric
D Replace
U Steam
U Suppl.
() Direct Vent
() Not Applicable
. Other
Use/Nature SFR / GAS RELINING / CHIMNEY BEING L1NED- LINER SIZE 6" MANUFACTURER 2 FLEX
of Work
Value
Value 175,000
Fees: Valuation $450.00
Issued By: ~~
Plan Approval
$0.00
Permit Fee Paid
$20.00
Date 03/21/2001
D Permit Voided I
suant to rules governing the described construction.
DatrJ 5<-;;2..1- 0 (
Signature
AgenUOwner
Address
PO BOX 1946
OSHKOSH
WI 54903 - 1946
Telephone Number (920) 279-0197
~
OfHKOJH
ON THE WATER
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5048
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JOB ADDRESS 901; B ,5 J.vJ t1 tr If
OWNER 5 -rev e: fr7 I-! ~ frV1 #7 f'.0 C? h CJ{ v.... :>
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CONTRACTOR B/~ ck L",--r- C h f JVJ;h ~L/
I
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE :3 ~ 1<] r- 0 (
CIRCLE ALL APPLICABLE
FAMILY
DUPLEX
MULTI-FAMILY
COMMERCIAL
INDUSTRIAL
FUEL
OIL
ELECTRIC
SOLAR
SOLID
SYSTEM
NEW
REPLACE
OTHER
TYPE
FORCED AIR
RADIANT
STEAM
Alc
VENT
ELECTRIC
HOT WATER
SUPPL.
b I'I
CON. BURNER
MANUFACTURER~ ~;,pxr
IS CHIMNEY BEING LINED Ye? LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
CHIMNEY A
CHIMNEY B
DIRECT VENT
OTHER
HEAT LOSS
AS APPROVED
EXISTING
NOT APPLICABLE
OTHER VALUE /7 r; 000 /3, J:CII.
BTU RATE
AS PER PLAN
VARIABLE
NATURE OF WORK: Go... 5
, ,
;..eIJi'l//
Valuation
Fees
$ 0 to $1, 0 0 0 . 0 0 .......................................................................................................................................$ 2 0 . 0 0
$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
OVe r $ 2 5 , 0 0 0 . 0 0 .......................................................................................................................................$ 3 0 5 . 0 0 plus $ 0 . 5 0
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.