HomeMy WebLinkAbout0099958-HVACOSHKOSH
ON THE WATER
,Job Address 1625 DEERFIELD DR
Contractor ANDRESEN SHEET METAL
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MICHAEL P FORD/P SCANLAN
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99958
01/17/2003
Other
Vent J
Use/Nature SFR/Add 3 heat runs to basement remodel job.
of Work
Fees: Valuation
Issued By:
$300.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 02/26/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2913 WITZEL AVE OSHKOSH WI 54904 -6539 Telephone Number
(920) 233-0323
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5054
R C : VED
HVAC
All information after bold categories must be p ' .
Incomplete applications will not be processed.
Q/HKO/B
ON THE WATER
· 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 m fees being ,doubled or $100.00 plus the
normal permit fee, which ever is greater. . -~..~, .., .
OR
If you are a contractor participating in th~ Permit fee Acdount System and: have' adeiqu~ate .£unds,' ~ch'eck here
(f you want this processed through your aecoant [-] :'
JOB ADDRESS /~2~'~
OW R
CHECK ~ ALL APPLIC~LE
USE CATEGORY
DSingle Fmily ' ~Duplex ~Mulfi-Fmily ~Rental
[] Commercial "[]'Industrial
FUEL FiOas FiElectric F1Solld SYSTEM []New FIReplace
FiOil FISolar []Other
TYPE
FIForced Air ElRadiant []Steam FIA/C F1Vent FIElectric FIHot Water []Suppl.
IS CHIMNEY BEING LINED FINo F1Yes - LINER SIZE fL/'/Z~& MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
Chimney A
[]As Approved
F1As Per Plan
[]Con. Burner
[~mney B
[]Existing
I-1Variable
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DESCRIPTION OF ALL WORK BEING DONE
FIDirect Vent
~lq~ot Applicable
[]Other Value
FiOther
VALUE (Including labor and all materials including light fixtures) $ ~) ' o
, ! ~ ',: :: :.~
ELECTRICAL CONTRACTOR
[] For applicable ProjeCts, an Electric InstallatiOn Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.