HomeMy WebLinkAbout0099997-HVACOSHKOSH
ON THE WATER
.lob Address 3234 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
99997
02/03/2003
Other
Vent J
Use/Nature NSFR/ Install heating system for new home.
of Work
Fees: Valuation
Issued By:
$4,855.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$78.50
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
HVAC PERMIT
All information after bold categories must be ;~oS~eq~/~'~r Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box i 128,
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
l_f you are a contract.or part~¢ipatin, g in the Permit.fee Account .System and have adequate funds, check here
if you want this processed thrOugh your account ~
DATE
CHECK [] ALL APPLICABLE
U~E CATEGORY
[~l~gle Family IZlDuplex ElMulti-Family ElRentat
ElCommerci.al
[-llndustrial
FUEL ~.Gas []Electric F1Solid SYSTEM []New FIReplace
' ElOil [3 Solar [3Other
ed Air []Radiant []Steam [A/C []Vent ElEleCtrie []Hot Water EISuppl. F1Con. Burner
IS CHIMNEY BEING LINED FINo []Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE []Chinmey A J~tChimney B
HEAT LOSS I~,As Approved []Existing
BTU RATE {~[As Per Plan F1Variable
DESC~,!PTION~OF ALL WO~ BEI~'~G DONE
& MANUFACTURER
0~kDireet Vent
[]Not Applicable
[3 Other Value
EiOther
VALUE (Including labor and all materials including light fixtures) $ q~OZ~'~, ~)0 7 &' ,JO
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors
3/02