HomeMy WebLinkAbout0091852-HVAC 0 CITY OF OSHKOSH No 91852
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2920 QUAIL CT Owner THOMAS W /SUSAN STARK Create Date 10/16/2001
Contractor BREWER HEATING Category 500 - Residential- Heating & Ventilating Plan
Fuel 1 Gas Oil I I Electric ( I Solar 1 I Solid
System 0 New 1 n Replace n Other
I
I_ Forced Air u Radiant u Steam u A/C u Vent
Electric I Hot Water ( I Suppl. I J Con. Bumer
Chimney Type 0 ) Chimney A O Chimney B • Direct Vent O Not Applicable
Heat Loss ) As Approved O Existing O Not Applicable I Value
BTU Rate j As Per Plan () Variable O Other Value
Use /Nature SFR/ In association with addition for master bedroom suite and inground pool.
of Work
Fees: Valuation $6,800.00 Plan Approval $0.00 Permit Fee Paid $107.00
Issued By: i(yh Date 12/17/2001
El 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
•
Division of Inspection Services
J 215 Church Avenue
/ w3 .O. Box 1130
0 1 -1K 0 ( I Oshkosh, WI 54903-1130
w.,uu Fax V (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
All fields /information after bold ctegories must be provided.
Incomplete applications w LiJ not be processed.
DATE to -II•U
JOB ADDRESS 6 9QO Q U t I L CT.
OWNER 70 STORK 4\61_00
CONTRACTOR • SREI.0 fA NeA T I M 6 4
CIRCLE ALL APPLICABLE
USE CATEGORY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL OIL ELECTRIC SOLAR SOLID
SYSTEM REPLACE OTHER
TYPE. FORCED AIR RADIAN STAN A/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 DTRECT VENT OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK:
VALUE (Including labor and materials) $ G0 9�``
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.