HomeMy WebLinkAbout0099996-HVACOSHKOSH
ON THE WATER
.lob Address 3222 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
99996
02/03/2003
Other
Vent J
Use/Nature NSFR/ Install heating system for new home.
of Work
Fees: Valuation
Issued By:
$4,615.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$75.50
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 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECeiVED
FEB
ON TH~ WATER
All information aIter bold categories
Incomplete applications will not be
O./HKO/H
C, reo iw
CONTRACTOR
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I 128. 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 par.ti~ipa.tin, g.i.n the permit.fee A. ccount .System and have adequate fun.ds., check here
~f you want this processed through .your account
M. or'?e, n ,
CHECK [] ALL APPLICABLE
CATEGORY
[3~gle Family ElDuplex
ElMulti-Family
r-lRental r-lCommercial l-IIndustrial
FUEL ~ []Electric E1Solid SYSTEM F1New ElReplaee
[]Oil [] Solar []Other
ced Air []Radiant []Steam [A/C []Vent [3Electric F1Hot Water []Suppl.[]Con. Burner
IS CHIMNEY BEING LINED .[]No [3Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be'.mg vented.
CHIMNEY TYPE 12Chimney A j~Chimney B
HEAT LOSS Ks Approved 12Existing
BTU RATE [2~ks Per Plan []Variable
DESCRIPTION OF ALL W(~RK BEING DONE
& MANUFACTURER
~i(Direct Vent
[]Not Applicable
[]Other Value
[]Other
YALUE (Inel.ding la, or and all materia:lsineluding light fixture,) $ZZ/;Z,/~9tz~fO. ~) O 7~ ~--0
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(~fReplacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
~/02