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HomeMy WebLinkAbout0100206-HVAC (furnace)OSHKOSH ON THE WATER .lob Address 1516 CENTRAL ST Contractor CUSTOM HEATING & COOLING Fuel ~J Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Oil Forced Air I ~J Radiant Electric I ~J Hot Water Owner DARRYL L SCHMIDT 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 I~ As Approved ~ Existing BTU Rate I~ As Per Plan ~ Variable Direct Vent Not Applicable Not Applicable Other Value Value No Create Date Plan L~ Solid 100206 03/14/2003 Other J Vent J Use/Nature SFR/replace furnace with a 60m btu and chimney liner. *EIV form from Hoehne Electric. of Work Fees: Valuation Issued By: $2,000.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $35.00 Date 03/14/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0 Telephone Number (920) 235-7263 City of O~lfl~osh Division of Imp~'tion S~vi~s P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 All i~omfion a~er bold categories must ~ provided. ~co~lete a~licafiom ~R not be process~. · Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1 I28. Commencing work without perm/t(s) will result in fees being doubled or $100.00 plus the normal lgxmit fcc, which ever is greater. OR If you arq q contractor partici_~atin~ in the Permit fee Aqc~nd have ad¢¢uate funds, ch¢ck ~.f.~ i w ntthis r ed through youraccq ntu~ C~CK l~ ALL APPLICABLE FUEL [~<~s i~Elcctric [3Solid ......... SYSTEM ..... E]New TYPE ms'em =Vent =E eo o Oaot water SuppLOCon. IS C~Y BErG L~ ~No ~Yes - L~R S~E ~// & M~AC~R C~Y TYPE E]Chimncy A VlChirnncy B ~ct Vent I:IEAT LOSS EIAs Approved EIExisting E]Not Applicable BTU RATE V1As Per Plan 13Variable [21Other Value VALUE (Including labor and ail materials including light fixtures) $ __ O~R ~ Electric Installation Verification form attached(lfP, cplacement) Electrical installation of new/replacement equipment shall be done by licensed contractors. ~/o2