HomeMy WebLinkAbout0088536-HVAC (line chimney) /0 CITY OF OSHKOSH
No 88536
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 902 WINDWARD CT Owner TED HOFF Create Date 06/11/2001
Contractor RASMUSSEN'S HEATING & A/C INC Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas 1 Oil Electric 1 Solar Solid
System I New I E Replace n Other
11 Forced Air u Radiant U Steam u NC u Vent
1 Electric Hot Water Suppl. 1 Con. Burner I
Chimney Type • Chimney A () Chimney B 0 Direct Vent n Not Applicable
Heat Loss ( ) As Approved 0 Existing • Not Applicable Value
1
BTU Rate 7 , ) As Per Plan 0 Variable O Other Value
Use /Nature SFR / LINE CHIMNEY
of Work
Fees: Valuation $250.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: IA/ Date 08/21/2001
1
❑ 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 5154 DAVID DR OSHKOSH WI 54904 - 0 Telephone Number 920 - 235 -6569
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Jun 06 01 05:29p Scott Noe 920 -232 -0455 p.1
Division of Inspection Services
�, 21S Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
Off
ON,MkWif Fax # (920) 236 -5084
Phone (920) 236 -5048
HVAC PERMIT APPLICATION;
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 6- 7-0
JOB ADDRESS iroa ;rAwc.rck
OWNER 7 V44142 1 j
CONTRACTOR RckS:fv, os 5 c v.' S
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR j SOLID
SYSTEM NEW REPLACE �TH
TYPE FORCED AIR RADIANT STEAM A /C =1
ELECTRIC HOT WATER SUPPL. 1 CON. BURNER
IS CHIMNEY BEING LINED }/�S LINER SIZE ,r MANUFACTURER Flcx► /ii4c -
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE�j
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK: 1 i n L° . h t Y►� j1 �y
VALUE (Including labor and materials) $ 5G.
ELECTRICAL CONTRACTOR N.A.
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 1 $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 1 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.