HomeMy WebLinkAbout0086252-HVAC
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OSHKOSH
ON THE WATER
Job Address 2015 HICKORY LA
CITY OF OSHKOSH
No
86252
HVAC PERMIT - APPLICATION AND RECORD
Owner ROBERT S PICKERI!'JG
Create Date 11/27/2000
Contractor RASMUSSEN'S HEATING & NC INC
Fuel 1,(1 Gas L I Oil
System D New
~ Forced Air U Radiant
I I Electric I 1 Hot Water
Chimney Type U Chimney A C) Chimney B
Heat Loss l) As Approved . Existing
BTU Rate () As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
~ Other
U NC U Vent
1 I Con. Burner
() Not Applicable
I Electric
D Replace
U Steam
U Suppl.
. Direct Vent
() Not Applicable
. Other
Value
Value Existing
Use/Nature SFR / Addition of 4 supply air ducts and 1 return
of Work
Fees: Valuation $500.00
Issued By: ..QmS
Plan Approval
$0.00
Permit Fee Paid
$20.00
Date OS/23/2001
D Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
5154 DAVID DR
OSHKOSH
WI 54904 - 0
Telephone Number 920-235-6569
... '
~pr 10 01 04:14p
Scott Noe
920-232-0455
p. 1
~
OJf-KOJH
ON THE: WAI'ER
Division of InspeCl:ion Service,s
2J.5 Church Avenue
P.O. Box 1130
Oshkosh. WI 54903-1130
Fax (920) 236-5034
Phone (~20} 236-504&
~lAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE~ _ JO -0\
JOB ADDRESS ~O t 5 ~. c..ko'rt
<lWNER R.. 'b...... p, rJ<.c.r ; "'~.
COlO"l'RACl'OR ~ ~ ^~mu.~('"o. ~.
CIRCLE ~~L APPLI~~LE
USE CATEGORY 0NGLE FAMILV
FUEL ~. OIL
DUPLEX
ELECTRIC
MULTI-FAMILY
COMMERCIAL INDUSTRIAL
SYSTEM
NEW
~RCED ~
ELECTRIC
REPLACE
SOLAR
C?TH~
STEAM Ale
SOLID
TYPE
RADIANT
VENT
HOT WATER
supp!..
CON. BUR..l.!ER
IS CHIMNEY BEiNG LINED 100 LINER SIZE
Note: All chimneys shall be sized per the BTU'g being ve~ted_
MANUFACTURER
CHnmBY TYPE
CHIMNEY A
AS APPROVED
CHIMNEY B
C!xIsTrn~
CDi-;ECT VE~
NOT APPLICABLE
OTHER
HEAT LOSS
BTU RATE
AS PER PLAN
VARIABLE
OTHER VALUE t=>< ty..r~
eAVc.+$ Av0. 1. re+urn
Valuation
Fees
$0 to $1,000. 00...._.._.___.__..__.____._._._.__._.__._......_._____.___________$20.00
$1 , 000 . 01 to $10, 000 . 00..___._...__.._..._______._..__.____._._.___.____..$ 2 0 . 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 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.