HomeMy WebLinkAbout0092761-HVAC
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OSHKOSH
ON THE WATER
Job Address 2645 HAMILTON ST
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
No
92761
Owner CREATIVE CUSTOM HOMES
Create Date 01/29/2002
Contractor VANS HEATING & AlC INC
Fuel [{j Gas UOil
System o New
~ Forced Air U Radiant
I I Electric I I Hot Water
Chimney Type K ) Chimney A () Chimney B
Heat Loss '. As Approved () Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
I I Solar I J Solid
o Other
U AlC U Vent
I J Con. Burner
() Not Applicable
U Electric
o Replace
U Steam
I ] Suppl.
. Direct Vent
() Not Applicable
() Other
Value
o
Value
Use/Nature NSFRllnstall new HVAC system.
of Work
Fees: Valuation
$3,976.00
Plan Approval
$0.00
Permit Fee Paid
$65.00
Issued By:
\<'vY\
Date 02/22/2002
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
AgenUOwner
Address
525 BUTLER ST
DEPERE
WI 54115 -5426
Telephone Number (920) 336-2816
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OJHKOJH
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
HVAC PERMIT APPLICATION
All
fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE {),;)/ckJ kJ~
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OWNER ex ea+l v~
CONTRACTOR \f tlY\'S;
ADDRESS ()JJ) 45 4-ctrn " \ -61\ cS-f-
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JOB
CIRCLE ALL APPLICABLE
USE CATEGORY ~FAM~ DUPLEX MULTI-FAMILY
FUEL eJ OIL ELECTRIC SOLAR
COMMERCIAL
INDUSTRIAL
SOLID
SYSTEM
REPLACE
OTHER
TYPE
RADIANT
STEAM
AIC
VENT
ELECTRIC HOT WATER
IS CHI~EY BEING LINEDtJD LINER SIZE
Note: All chimneys shall be sized per the BTU's
SUPPL.
CON. BURNER
MANUFACTURER
being
vented.
~
NOT APPLICABLE
OTHER
CHIMNEY TYPE
CHIMNEY A
CHIMNEY B
BTU RATE
PER PLAN
VARIABLE
OTHER VALUE
HEAT LOSS
APPROVED
EXISTING
NATURE OF WORK: N e.o.) Co (\'5;.J-.v-u..ch 0 n
VALUE (Including labor and materials) $~ 'f17 &, ().5!
ELECTRICAL CONT~~CTOR___
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation
Fees
$ 0 to $1, 000 . 0 0 .......................................................................................................................................$ 2 0 . 0 0
$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 , 0 0 0 . 0 1 to $ 2 5 , 0 0 0 . 0 0 ............................................................................................................ $15 5 . 0 0 f or fir s t
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $ 25 , 00 0 . 0 0 ..........................................................................".....~......~~..............................~.........~....$ 3 05 . 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.