HomeMy WebLinkAbout0097054-HVAC
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OSHKOSH
ON THE WATER
Job Address 2720 HAMILTON ST
CITY OF OSHKOSH
No
97054
HVAC PERMIT - APPLICATION AND RECORD
Owner THOMAS N RUSCH
Create Date 07/17/2002
Contractor VANS HEATING & AlC INC
Fuel 1-cJ Gas I Oil
System o New
~ Forced Air U Radiant
U Electric I I Hot Water
Chimney Type ~) Chimney A () Chimney B
Heat Loss . As Approved C) Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
I Electric
D Replace
U Steam
I I Suppl.
() Direct Vent
I I Solari Solid
D Other
U AlC U Vent
I I Con. Burner
. Not Applicable
C) Not Applicable
() Other
Value
o
Value
Use/Nature NSFRllnstall furnace & ductwork.
of Work
Fees: Valuation
Issued By: ~ 'fI\
$4,026.00
Plan Approval
$0.00
Permit Fee Paid
$66.50
Date 09/04/2002
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 525 BUTLER ST
DEPERE
WI 54115 - 5426 Telephone Number (920) 336-2816
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City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VV154903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
. Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If VOll are a contractor oarticioatinz in the Permit fee Account Svstem and have adeauate funds, check here
dvou want this orocessed through vaur account n
DATE ~-~~-O:<
JOB ADDRESS ~ '7;).CJ !+am j llv" J f-
OWNER C r eLL h V'~ Cv.sh /Y\ /-Jam es
CONTRACToR-1!llnf' J.ka.h~ "'- f}-lr (!IJ~.
CHECK 0 ALL APPLICABLE
USE CATEGORY
~Single Family DDuplex DMulti-Family
o Rental
o Commercial
o Industrial
FUEL
~Gas
DOil
DElectric DSolid
o Solar
SYSTEM
~New
o Other
DReplace
TYPE
W'orced Air DRadiant DSteam DAlC DVent DElectric DHot Water DSuppl.DCon. Burner
IS CHIMNEY BEING LINED I8JNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
REA T LOSS
BTURATE
DChimney A
ts4As Approved
~As Per Plan
DChimney B
o Existing
DVariable
DDirect Vent o Other
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE 1urnCiue.. ..L cLuc~WtJrt /~slal/ed In
A)eJD ('(!)1'-s.J.-ru_<.iwA t9-- sf.o~ h..6 r'-'I-~-
VALUE (Including labor and all materials including light fixtures) $10;lG ~
ELECTRICAL CONTRACTOR
OR 0 Electric Installation Verification form attached(lf Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02