HomeMy WebLinkAbout0102828-HVAC (a/c)OSHKOSH
ON THE WATER
Job Address 160 FARMSTEAD LN
MARTENS HEATING & COOLING
[] New
Forced Air I
Contractor
Fuel
System
Electric
Chimney Type ~ ChimneyA
Heat Loss ~ ~ As Approved
BTU Rate ~..) As Per Plan
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
~j Radiant
LI Hot Water
Chimney B
~..) Existing
(.) Variable
Owner MATTHEW L BUTKIEWICZ
Category 501 - Residential-Air Conditioning
I I Electric ~ Solar
[] Replace
Steam Ld NC
I' Suppl. ] I Con. Burner
Direct Vent ~ Not Applicable
Not Applicable I Value
Other I Value
No 102828
Create Date 07/14/2003
Plan
[] Other
LJvent
Use/Nature ~FPJ install central air.
of Work
Fees: Valuation
Issued By:
$950.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$20.00
Date 07/14/2003
In the performance of this work, I agree to perform all work pumuant to rules governing the described construction.
Signature Date
Agent/Owner
Address P.O. BOX 106 WAUKAU Wi 54980 - 106 Telephone Number (920) 685-0111
City of Osl~osh
Division of Inspection Services
P,O, Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
Application(s) and fee(s) cm be brought to CiW Hall, Room 205 ar ~led to hspecfion Se~ces, PO Box 1128,
Oshkosh WI 54903-1128. Co~eneing work wifl~out pemit(s) will ~sult in fees ~g doubled or $100.00 plm ~e
no~al pemit fee, which ever ~s ~eater.
OR
~re a contractor partic~pa,tin~ in th~ per.it fee Account SFste~ and ~ave adeq,uat~ funds, check here
~ou wan~ th~&procesxed through your account ~
CAamGO ' '
~ngle Family IZIDuplex IZ1Mulfi-Fam~ly
[ZlRental IZICommercial [ZIIndustrial
FUEL []Gas IZlEleetric ~Solid SYSTEM ISlNew V1Replaee
[]Oil [3 Sol,ar F1Other
TYPE amigA/
[]Forced Air []Radiant DSte C []Vent []Ele~tr/c F1Hot Water ISlSuppt.[]Con. Burner
Note: All ehixrmeys shall be sized p~r tl~e BTU s be!rig vented.
CItlMNEY TYI~E [3Chimney A [3Chimney B []Direct Vent []Other
II[EAT LOSS [S1As Approved V1Existing []Not Applicable
BTU RATE ~]As Per Plan [3Variable []Other Value
DESCRIPTION OF ALL WORK BEING DONE__~
VALUE (Including labor a~ad all matermls mclud,mg hght fixtm es) ~
ELECTPdCAL CON~CTOR~~bd Q~ ~ Elac~ lnstatlation Ve~fiea,fl:~ form a~ached(lfR~lacem~t)
Electrical tnstall~n of new/re~aeement equlpmem shall be done ~ l~ensed contra~o