HomeMy WebLinkAbout0099992-HVACOSHKOSH
ON THE WATER
.lob Address 3210 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 & DEVELOP
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
99992
02/03/2003
Other
Vent J
Use/Nature NSFR/ Install heating system for new home.
of Work
Fees: Valuation
Issued By:
$5,215.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$84.50
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 I 130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ON THE WATER
All information after bold ~a}~l~Tt~l~ Incomplete applications will not be
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 contractor par.t.~cip.a..tin.~ in t.he Permit fee. A. ccount .System and have adequate_funds, check here
if you want this processed thrOugh ~our account ~
DATE
CttECK ~ ALL APPLICABLE
nCATEGO:RY
gle Family EIDuplex E1Multi-Family ElRental
rqCommercial
r-Ilndustrial
FUEL ~Gas EIElectric [3Solid SYSTEM E1New E1Replaee
ElOil [3Solar [3Other
TyPE
~,?.rced Air IDRadiant EISteam E1A/C [3Vent ElElectric Elliot Water ~Suppl.l-lCon. Burner
IS CmMNEY BEING LINED [3No I'qYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CI:IIMNEY TYPE [3~Chimney A ~[Chimney B J~Direet Vent FlOther
HEAT LOSS l~,As Approved FlExisting F1Not Applicable
BTU RATE ~l,As Per Plan [3Variable F1Other Value
VALUE (Including labor and all materials includi:ng light fixtures) $ ,~T.~ /6-"' ~ ¢ 5°
ELECTRICAL CONTRACTOR OR ...... [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
3/02