HomeMy WebLinkAbout0095253-HVAC (a/c) I CITY OF OSHKOSH No 95253
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 2601 BADGER AVE Owner MARK CUMINGS Create Date 06/18/2002
Contractor MARX MECHANICAL LLC Category 511 Ind. Comm -Air Conditioning Plan
Fuel Gas I Oil Electric
Solar I Solid
System New I 0 Replace 1 n Other
Li Forced Air Li Radiant u Steam u NC u Vent
Electric I I Hot Water 1 Suppl. I Con. Bumer
Chimney Type K Chimney A Chimney B O Direct Vent Not Applicable
Heat Loss As Approved 0 Existing Not Applicable Value 0
BTU Rate 3 As Per Plan O Variable Other Value 5 ton
Use /Nature IND/ Replace existing a/c.
of Work
Fees: Valuation $2,200.00 Plan Approval $0.00 Permit Fee Paid $38.00
Issued By: \"4.1p/N Date 06/19/2002
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 6304 Telephone Number (920) 235 -6510
38
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
C r 111111 4--
Phone (920) 236 -5050
Fax (920) 236 -5084 OJHKOJH
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
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 1128,
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
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account E
11 ��ff�� DATE 1.p"
JOB ADDRESS o2 �0 I 1'!J G_
OWNER RV JPLL RL '1
CONTRACTOR M 1\4 eb -tip 0-\-c, 10
CHECK El ALL APPLICABLE C 1
USE CATEGORY
Mingle Family ❑Duplex ❑Multi Family :Mental tilConunercial ❑Industrial
FUEL DGas rgiElectric ❑Solid SYSTEM ❑New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
❑Forced Air ❑Radiant ❑Steam'A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Bumer
IS CHIMNEY BEING LINED ❑No ❑Yes LINER SIZE MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable
BTU. RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION OF ALL WORK BEING DONE QIEY �Ti N l J
w ■T 1,eNNoxc }-�s2c c�El
VALUE (Including labor and all materials including light fixtures) a 0/N
ELECTRICAL CONTRACTOR vi O J J et OR Electric Installation Verification form attached(lf Replacement)
Electrical installation of new /replacement equipment shall be done by licensed contractors.
3/02