HomeMy WebLinkAbout0100357 HOSHKOSH
ON THE WATER
.lob Address 901 JACKSON ST
Contractor LEHR HEATING AND PLUMBING INC
Fuel ~J Gas ~
System ~J New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner D & M RENTALS LLC
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100357
03/05/2003
Other
Vent J
Use/Nature
of Work
Duplex/ 2 story upper/lower.
Fees: Valuation
Issued By:
$9,950.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$155.00
Date 03/24/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX36 Wautoma WI 54982 -0
Telephone Number
920-787-3426
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 23{;-5050
Fax (920) 236-5084
HVAc PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON TNE WATFR
· 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 £ee Account System and have adequate funds,, check here
if you want this processed through Four account ~]
CHECK [] ALL APPLICABLE
USE CATEGORY
mSingl¢ Family .l~Duplex
IZlMulti-Family
IZIRental F1Commercial nlndustrial
FUEL ~lGas FIElectric [2]Solid
FIOil F1Solar
TYPE
[2]Forced Air []Radiant FISteam F1A/C I"lVent
IS CHIMNEY BEING LINED []No F1Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[]Chimney A
r'lAs Approved
mAs Per Plan
[]Chimney B
F1Existing
FiVariable
DESCRIPTION OF ALL WORK BEING DONE
SYSTEM I~INew FIReplace
F1Other
[]Electric l~lHot Water F1Suppl. FiCon. Burner
& MANUFACTURER
F1Direct Vent
[]Not Applicable
FIOther Value
FiOther
VALUE (Including labor and all materials including light fixtures) $ ~ g .~0. O~)
ELECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02