HomeMy WebLinkAbout0097487-HVAC (furnace)
,.,.
e
OSHKOSH
ON THE WATER
Job Address 901 HARN Y AVE
CITY OF OSHKOSH
No
97487
HVAC PERMIT - APPLICATION AND RECORD
Owner VICKI M MOEN
Create Date 09/24/2002
Fuel
UOil
1 Solar U Solid
D Other
~ AlC U Vent
U Con. Burner
Contractor
Chimney Type
U Radiant
U Hot Water
Chimney B
Category 502 - Residential-Both
l,(1 Electric
~ Replace
U Steam
U Suppl.
Plan
System
Direct Vent
Not Applicable
Heat Loss
Existing
Variable
Not Applicable
Other
Value 0
BTU Rate
Value 75m btu
Use/Nature
of Work
Fees: Valuation
$4,500.00
Plan Approval
$0.00
Permit Fee Paid
$72.50
Date 09/24/2002
Issued By:
D Permit Voided I
In the performance of his work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
1736 S STREET
GREEN BAY
WI 54302 - 0
Telephone Number (920) 468-6951/235-E
\01'\
Cit)< of Oshkosh
Division of Inspe tion Services
P.O. Box 1130
Oshkosh, WI 549 3-1130
Phone (920) 236- 050
Fax (920) 236-5 84
ON THF WATFR
HV AC 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 W 54903-1128. Commencing work without pcrmit(s) will result in fees being doubled or $100.00 plus the
normal pe it fee, which ever is greater;
OR
I ee Account Svstem and have ade uate unds check here
DATE
1 / ~ 5 / {)v
OWNER
1(J1 HI1t2tJIJY ME
761<.1 M 0 € ,J
W 6 S LeV €"m-itJ 6
&JeLl AJ6.
L APPLICABLE
ODuplex OMulti-Family
o Rental
o Commercial
OIndustrial
FUEL
li?jEl~ DSolid
DSolar
SYSTEM
~ew f!~ p(Replace Fut8tJi'M&
o Other
TYPE
;KJForced Air Radiant DSteam~C DVent DElectric DHot Water DSuppl.DCon. Burner
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE
Note: All chimn ys shall be sized per the BTU's being vented.
& MANUFACTURER
DChimney A
DAs Approved
DAs Per Plan
DChimney B
,fQExisting
DVariable
1s:(Direct Vent o Other
DNot Applicable
o Other Value 751 000
Bru t.s"
CHIMNEY T
HEAT LOSS
BTURATE
/J J T1h.,.f-
0751..)3
CIH!...- If} 11 I)/~ I d- f3 3 ()
ing labor and all materials incIudin~ight fixtures) $ r $'00. 00
7R r;; C, t S I 0 tJ E: f.-.E rtj/c ( V
/{
G~.5 0)
~
CONTRACTOR
OR 0 Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
3/02