HomeMy WebLinkAbout0095481-HVAC CITY OF OSHKOSH N 95481
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2388 SHORE PRESERVE DR Owner OSHKOSH AREA SCHOOL DISTRICT Create Date 09/11/2001
Contractor CENTRAL HEATING SERVICE INC Category 502 - Residential -Both Plan
Fuel 11 Gas I Oil 1 Electric I I Solar I 1 1 Solid
System 0 New n Replace I 0 Other
U Forced Air u Radiant u Steam u NC HI Vent
Electric 1 Hot Water 1 1 Suppl. I Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable I
Heat Loss 0 As Approved 0 Existing 0 Not Applicable 1 Value 0
BTU Rate le As Per Plan 0 Variable 0 Other
Value
Use /Nature NSFR/ Install new HVAC system.
of Work
Fees: Valuation $7,280.00 Plan Approval $0.00 Permit Fee Paid $114.20
Issued By: \ irVA Date 06/26/2002
❑ 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 1565 HARRISON STREET OSHKSOH WI 54901 - 0 Telephone Number (920) 235 -6670
ED Division of Inspection Services
215 Church Avenue
P.O. Box 1130
H Osh WI 54903 -1130
N H w,,„ 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 (p l5 /OZ
JOB ADDRESS 2-3 irg Sh6Y.Q "; i2- swo`f
OWNER o it/ W 7 $ )+ A W � ii - 5ZN P/ 7 /210T
CONTRACTOR C E,() r- r2 A L t-1 T CQ . S L e i i , / A) (
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI - FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM _ice'- REPLACE OTHER
TYPE FS•CED AI• RADIANT STEAM di.' 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 DIRECT VENT OTHER
HEAT LOSS A APPROVED EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN ° VARIABLE OTHER VALUE
NATURE OF WORK:
F) V/c
VALUE (Including labor and materials) $ - 7a sb * •
ELECTRICAL CONTRACTOR
Electrical installation of new /replacement equipment shall be done by licensed
contractors. 4
Valuation Fees 1 / L Y, C
$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.