HomeMy WebLinkAbout0097780-HVAC
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OSHKOSH
ON THE WATER
Job Address 2738 HAMILTON ST
CITY OF OSHKOSH
No
97780
HVAC PERMIT -APPLICATION AND RECORD
Owner THOMAS N RUSCH
Create Date 07/17/2002
Contractor VANS HEATING & AlC INC
Fuel 1,(1 Gas I Oil
System ~ New
~ Forced Air U Radiant
I I Electric I I Hot Water
Chimney Type U Chimney A U Chimney B
Heat Loss . As Approved C) Existing
BTU Rate . As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
l I Solar U Solid
o Other
U AlC U Vent
L I Con. Burner
. Direct Vent C) Not Applicable
() Not Applicable
() Other
Value
o
Value
Use/Nature NSFRllnstallation of furnace & ductwork. * Job #118812.
of Work
$3,894.00
Plan Approval
$0.00
Permit Fee Paid
Fees: Valuation
$63.50
Issued By: K M
Date 10/07/2002
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
Agent/Owner
Address
525 BUTLER ST
DEPERE
WI 54115 - 5426 Telephone Number (920) 336-2816
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J()b * II ~ % I d
~ JRE~EIVED@
\~iy &1> OCT 0 12002 ~
?J(5' \J)~ 'lJfJ:J. DEPARTMENT OF Oftj~Q!.H
HV AC PERMIT API='LOf8A~~NDEVELOPMENf
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI54903-ll30
Phone (920) 236-5050
Fax (920) 236-5084
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 vou are a contractor participating in the Permit fee Account Svstem and have adeauate funds, check here
if vou 'want this processed through vour account n
DATE
1-85-0;;1
JOB ADDRESS a- '7 ~ ~m~ l-k 11 Skeel u,fP /,J/
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OWNER Cr ep.:h J--e..-
CONTRACTOR VUY\~
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CHECK 0' ALL APPLICABLE
USE CATEGORY
~Single Family DDupl~x
DMulti-Family
DRental
o Commercial
o Industrial
FUEL
.RIGas
DOil
DElectric DSolid
DSolar
SYSTEM
,-al'New
o Other
DReplace
TYPE
~Forced Air DRadiant DSteam DAlC DVent DElectric DHot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented,
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
P(As Approved
~As Per Plan
DChimney B
DExisting
DVariable
~irect Vent o Other
DNot Applicable
DOther Value
DESCRIPTION OF ALL WO}U( BEING DONE . J f\.)Ja lJ&thofl oJ ~r'n&C<: ""-
r},1 Lei- (j.Jo i..-k I (\ f\ e w r () f) <:; f f' tA G-h 7J r\.
VALUE (lncl,uding labor and all materials including light fixtures) $ 3 ??Cf'-l~
ELECTRICAL CONTRACTOR t 10 Ve..
OR 0 Electric Installation Verification form attacbed(If Replacement)
Electrical installation of new /replacement equipment shall be done by licensed contractors.
3/02