HomeMy WebLinkAbout0083751-HVAC CITY OF OSHKOSH N 83751
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 474 WINDINGBROOK DR Owner JAMES R/BILLIE J MATHUSEK Create Date 12/19/2000
Contractor BREWER HEATING Category 502 Residential -Both Plan
Fuel v' Gas 1 011 Electnc Solar Solid
System 71 Nerd Replace Other
Forced Air Radiant Steam ✓1 A/C Vent
i 1 Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A O Chimney B 0 Direct Vent Not Applicable
Heat Loss K As Approved Existing O Not Applicable Value
BTU Rate As Per Plan Variable Other Value 75,000
Use /Nature NSF I.( INS TALL NEW FURNACE NU FUK NEW HUME
of Work
Fees: Valuation $4,400.00 Plan Approval $0.00 Permit Fee Paid $71.00
Issued By: Date 01/18/2001
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address N8804 N DOUGLAS STREET RIPON WI 54971 0 Telephone Number (920)748 -6494
41;) Division of Inspection Services
215 Church Avenue
P.O. Box 1130
O O Oshkosh, WI 54903
�j Fax (920 236 -50
ON THE WATER
Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
''1 DATE ia•01
JOB ADDRESS 47 WINDING BROOK.
OWNER G AUER'1 WonES
CONTRACTOR j W E N E flT I N G
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMI Y DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS' OIL ELECTRIC SOLAR SOLID
SYSTEM A REPLACE OTHER
TYPE ORCED RADIANT STEAM /C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B •IRECT VE■ OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE '75000
NATURE OF WORK: {-J V A(/ U
1\
VALUE (Including labor and materials) `i
ELECTRICAL CONTRACTOR
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 to $1,000.00 $20.00
$1,000.01 to $10,000.00
$20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 $305.00 plus $0.50
per $100.00 valuation or part thereof
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.