HomeMy WebLinkAbout0097895-HVAC 6 CITY OF OSHKOSH No 97895
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2381 SHORE PRESERVE DR Owner TONY LITJENS Create Date 09/04/2002
Contractor BREWER HEATING Category 502 - Residential -Both Plan
Fuel 11 Gas I 1 011 I Electric 1 Solar I Solid
System 0 New 1 n Replace I ❑ Other
u Forced Air U Radiant Steam u A/C u Vent
Electric I Hot Water I Suppl. I I Con. Burner
Chimney Type ..) Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss ` ) As Approved () Existing • Not Applicable Value 0
BTU Rate Z ) As Per Plan () Variable • Other Value
Use /Nature NSFR/ Install HVAC system for new home.
of Work
Fees: Valuation $5,600.00 Plan Approval $0.00 Permit Fee Paid $89.00
Issued By: T \ Date 10/09/2002
❑ 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
RECEIVED City of Oshkosh
Division of Inspection Services
OCT 0 9
P.O. Box 1130 2.00
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 DEPARTMENT OF
Fax (920) 236-5084 COMMUNITY DEVELOP tQ� KOJH
COMMUNITY
THE WATER
HVAC PERMIT APPLICATION !r l
All information after bold categories must be provided. n �lJ�'
Incomplete applications will not be processed.
• 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 partic patink in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account n
DATE 10 - 3. 0
JOB ADDRESS A3 g l Si-I Ofi E PR F S Ev
OWNER TONY L, T J E LS Q
CONTRACTOR 1 EL J EF EA rI N G
CHECK El ALL APPLICABLE
USE CATEGORY
S ingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
FUEL '146as ❑Electric ❑Solid SYSTEM ;New ❑Replace
❑Oil ❑Solar ❑Other
TYPE
?EfForced Air ❑Radiant DSteamyA/C ❑Vent DElectric ❑Hot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE - & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B Wirect Vent ❑Other
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION OF ALL WORK BEING DONE v'A 4
VALUE (Including labor and all materials including light fixtures) $ S 00
ELECTRICAL CONTRACTOR OR ❑ Electric Installation Verification form attached(lf Replacement)
Electrical installation of new /replacement equipment shall be done by licensed contractors.
3/02