HomeMy WebLinkAbout0086254-HVAC (re-vent furnace)
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OSHKOSH
ON THE WATER
Job Address 868 HARMEL AVE
CITY OF OSHKOSH
No
86254
HVAC PERMIT -APPLICATION AND RECORD
Owner JAMES H PRIVOZNIK
Create Date 04/24/2001
Contractor RASMUSSEN'S HEATING & AlC INC
Fuel ~I Gas LIOil
System o New
l!J Forced Air U Radiant
U Electric U Hot Water
Chimney Type Chimney A Chimney B
Heat Loss KJ As Approved ( ) Existing
BTU Rate U As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
LI Solar U Solid
o Other
U AlC U Vent
U Con. Burner
U Electric
o Replace
U Steam
U Suppl.
Direct Vent Not Applicable
() Not Applicable Value
() Other Value
Use/Nature SFR/ Re-venting the sealed combustion furnace out the side of the house and lining the chimney for the water heater.
of Work
Fees: Valuation $550.00
Issued By: ~ S
Plan Approval
$0.00
Permit Fee Paid
$20.00
Date OS/23/2001
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
5154 DAVID DR
OSHKOSH
WI 54904 - 0
Telephone Number 920-235-6569
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.A?r 23 01 OS:5Sp
Scott Noe
920-232-0455
p. 1
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OJFKOJH
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Division o~ Inspeccion Services
215 Church Avenue
P.O. Box 113()
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
nvAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 4-;;?' 5 -0 \
JOB ADDRESS &<;,8 }-\A....YAC- \
OWNER '"S o..'IY\.e.S ? r";VO c.V\, k
CONTP._~CTOR Ro.s.Y'Y\."''!>5c.n\~ HV AC-
CIRCLE ALL APPLICABLE
USE CATEGORY (SINGLE FAMILY DUPLEX
FUEL @.J OIL ELECTRIC
MULTI-FAMILY COMMERCIAL
INDUSTRIAL
TYPE
RADIANT
SOLAR SOLID
~
STEAM Alc VENT
SYSTEM
NEW
(fORCED A~
ELECTRIC
REPLACE
HOT WATER
SUPPL.
CON. BlJRNER
IS CHIMNEY BEING LINED LINER SIZE 30
Note: All chimneys shall be sized per the ETa's being vented.
MANUFACTURER P/e.)i., \ tnc:Y'
CHIMNEY TYPE
(grIMNEY U
AS APPROVED
CHIMNEY B
~XISTINQ)
VARIABLE
DIRECT VENT
OTHER
HEAT LOSS
NOT APPLICABLE
BTU RATE N." AS PER PL.1L1IJ
OTHER VALUE
NATURE OF WORK: liY\e. ~........,""ne1, o.ll 5 Kui+lc:.. Md..ke- up ()..\Y" 1 o..vuA
Vent +Uf'no..L~ p'fbpu \r
VALUE (Including labor and materials) $ 550.00
ELECTRICAL CO~ITRACTOR tJ.P\
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation
Fees
$ 0 to $1, 0 (} (} . 0 0 ...................................................._..........................................................._......._...........$ 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
$10,000.01 to $25,00 0 .00............................................................................................................$155.00 for first
$10/000.00 plus $1.00 per $100.00 valuation or part thereof
Over $ 2 5 , 000 .. 0 0.........................................................................................................._...........................$305 .00 pI us $ 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
great.er.