HomeMy WebLinkAbout0099995-HVACOSHKOSH
ON THE WATER
.lob Address 3230 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
99995
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 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
FEB 2 $"
O/H,KO/H
All information after bold categories must be ~[o~vi~l.-}0PME~T Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to Ci~ Hall, Room 205 or mai}ed to hspecfion Semites, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pemit(s) will result in fees berg doubled or $100.00 plus the
nomal pemt fee, which ever is ~emer.
OR
~re a contractor part~cipa, tine tn the Permit fee 4ccount System and have adequate fu~.d~, check here
~you want this .processed thrOugh Your hc count ~ DATE ~'~-D 3'
CHECK [] ALL APPLICABLE
CATEGORY
[~ngle Family F1Duplex [3Multi-Family [3Rental
DCommercial
IDIndustrial
FUEL ~as []Electric ElSolid SYSTEM []New []Replace
[3 Oil [] S olaf [] Other
TYPE
arcedAir ElRadiant ElSteam EIA/C [3Vent []EleCtric EIHot Water EISuppl. El'Con. Burner
IS CHIMNEY BEING LINED EINo I'lYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be'.mg vented.
CItIMNEY TYPE []Chimney A j~Chimney B ~Direet Vent []Other
HEAT LOSS ~/s Approved []Existing ElNot Applicable
BTU RATE ~As Per Plan ElVariable F1Other Value
DESCRIPTION OF ALL WO~ BEING DONE ~ . ~ ff~O~.../Z'~
& MANUFACTURER
VALUE (Including labor and all materials including light fixtures) ~; b~'~/~ O~ ~' d2//..~'~_~
OR [] Electric Installation Verification form attached(If Replacement)
ELECTRICAL CONTRACTOR ~ectrical installation of new/replacement equipment shall be done by licensed contractors
3/02