HomeMy WebLinkAbout0099991-HVACOSHKOSH
ON THE WATER
.lob Address 3242 BELLFIELD DR
Contractor MARTENS HEATING & COOLING
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CREATIVE CUSTOM HOMES
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss IO As Approved ~ Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99991
02/03/2003
Other
Vent J
Use/Nature NSFR/ Install heating system for new home.
of Work
Fees: Valuation
Issued By:
$4,315.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$71.00
Date 02/28/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number
(920) 685-6244
City of Oshkosh
Division of Inspection Services
P..O. Box 1130
Oshkosh, WI 54903~1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC OF'
All information after bold ~~ ~s~ffbb)~j~Lc~g/~rg~v
Incomplete applications ~11 not be processed.- ....... '~
Q/HKO/H
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 in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contract.or par.t(cipa, tin. g in the Permit fee A. ccount System and have adequate :funds. check here
~f You want this processed through your account '[~]
DATE
CItECK [] ALL APPLICABLE
USE CATEGORY
~t~ingle Family V1Duplex
V1Multi-Family
ElRental VlCommercial r-llndustrial
FUEL t~as [Electric []Solid SYSTEM V1New []'Replace
[]Oil VI Solar []Other
TYPE
~3~orced Air V1Radiant []Steam EIA/C []Vent []Electric []:]Hot Water VISuppl. V1Con. Burner
IS CItlMNEY BEING LIt, rED F1No r'qYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be'rog.vented.
CRI1VFNEY TYPE []Chimney A ~Chimney B [~Direet Vent []Other
ItEAT LOSS [~S(,As Approved []Existing []Not Applicable
BTU RATE ~.As Per Plan []Variable •Other Value
or ALL WOmC. BEIN
DESCRIffTION
& MANUFACTURER
VALUE (Including labor and all materials including light fixtures) $ q.~/,.5-~ 0 ~) /~/7/' ~ t~)
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(~fRep]acement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
3/02