HomeMy WebLinkAbout0099993-HVACOSHKOSH
ON THE WATER
.lob Address 3218 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
99993
02/03/2003
Other
Vent J
Use/Nature NSFR/ Install heating system for new home.
of Work
Fees: Valuation
Issued By:
$3,955.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$65.00
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
FEB 2
Allinfor~tionafterb 1 g ' p '' .
Incomplete applications will not be processed.
O./HKb/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-I 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
~f you are a contrac, tor participatin, g in the P~rmit fee A. ccount System .and have ~d~.q.uate _funds, c.heck here
~£you want this Processed through your account ~
owx a ,reMi',ve- u 'i rn , ......
CHECK [] ALL APPLICABLE
.CATEGORY
gle Family F1Duplex ElMulti-Family E]Rental
[]Commercial
Fllndustrial
FUEL '~Gas F1Electric FISolid SYSTEM' FiNew FIReplace
FIOil [] Solar [3Other
tE
rced Air []Radiant l-lSteam [A/C FiVent ElEleCtric' F1Hot Water Fi Suppl. l-l Con. Burner
IS CH1TdN-EY BEING LINED :FINo FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's berg vented.
& MANUFACTURER
CHIMNEY TYPE [3Chimney A t{~Chimney B ~Direct Vent F1Other
HEAT LOSS J2~A. s Approved [3Existing FINot Applicable
BTU RATE [~s Per Plan F1Vafiable F1Other Value
ELECTRICAL CON~CTOR OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors