HomeMy WebLinkAbout0100307-HVAC (furnace)Oct 2! 02 03:33p
Oshkosh
Inspections
920-236-5084
p.1
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
Ail information after bold categories mast be provided.
Incotr~lete applications will not be processed.
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ON THE WATER
· 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_ participatin~ in the Permit fee Account System and have adequate funds, check here
if vozt want this processed through 1,our account FI
USE CATEGORY ~u
nSingle Family FIDuplex ltl-Family nRental F1Commercial Fllndustrial
FUEL X~as EIElectric IDSolid SYSTEM FINew )~eplace
nOil FISolar FIOther
/~Eeed Air ElRadiam E1Steam El)dC OVent FIElectric
IS CIIIM_NEY BEING LINED~o Fl~es ' L1NER SIZE. , ~ ~
Note: All chimneys shall be sized p~ the BTU s being vented.
CItIMNEY TYPE nChimey A /~inmey B F1Direct Vent FIOther
BEAT LOSS [:lAs Approved '~isting ' F1Not Applicable
BTU RATE F1As Per Plan ' ~riable ElOther Value
EIHot Water EiSuppl. EICon. Burner
VAJoUE (Including labor and ali materials including light fixtures) $
[2 For applicable projects, an Elecu-ie Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
5/02
03/20/03 09:44 FAX 920 236 7725 Solar Electrlc
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Electric In !!ation Verification
Oi~Uic~l ~
(Adm~ss) (city)
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The value ot'this work is $
I h~reby v~ify {his work will bc p~ri'om~ by an ~mqmloy~ 'ofthis oompimy ami fiui{~ v~rify
thc ru~ouaw/ou t hsmllaIiou will b~ dom: in ~mupliauo~ wi~ mauufa~rur mad l~iu~uic ~
ti%in! Namt~ of Oilier)