HomeMy WebLinkAbout0084491-HVAC (boiler) 0 CITY OF OSHKOSH N 84491
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2024 E MURDOCK AVE Owner HAROLD E WEISS Create Date 03/01/2001
Contractor DRUCK'S PLBG & HTG & CLG Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas I 011 Electric Solar Solid
System New ✓ Replace Other
( Forced Air I Radiant 1 Steam I A/C _ Vent
Electric ✓I Hot Water 1 Suppl. Con. Burner
Chimney Type 0 Chimney A ( ) Chimney B ( ) Direct Vent ( ) Not Applicable
Heat Loss ( ) As Approved i Existing ( ) Not Applicable Value
BTU Rate ( ) As Per Plan O Variable 0 Other Value 175,000
Use /Nature SFR / Replace boiler
of Work (No electric permit required- received installation verification signed by Solar Electric)
Fees: Valuation $4,300.00 Plan Approval $0.00 Permit Fee Paid $69.50
Issued By: .31T73 Date 03/01/2001
h
1 Permit
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 504 3RD ST P 0 BOX 355 MENASHA WI 54952 - 0 Telephone Number (920) 426 -2654
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
Fax # (920) 236 -5084
w w Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 2 8 " 49,/
JOB ADDRESS ,2. 7 L/ t Atio y.
OWNER //f,4i' L 4 '6/$ $ Z' y(•v r
CONTRACTOR /J llLW.s A 51° q' 09
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY) DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLACE OTHER
TYPE FORCED AIR RADIANT STEAM A/C VENT
ELECTRIC (1/1-OT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED i(/O 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 AS APPROVED EXISTIN ) NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE /7si ' '
NATURE OF WORK: /cr2L/rC(- �' "/ 44
VALUE (Including labor and materials) $ Y3Pao v
ELECTRICAL CONTRACTOR , ELfC7/,� /C
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$ o to $1, 0 0 0.0 0....._...._..........._. .................. . .._..............._........$ 2 0 .0 0
$1,000.01 to $ 1 0 , 0 0 0 . 0 0 _ $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.
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• Electric Installation Verification
(1) Me) .504.44 eiee"A{re
(EJectrien) CmlraetOr Name)
(Addresses) (CinY) (Sue) (71p Code)
have bees contracted to perform electric installation work for 44 oreadr;
(Name of pasty connected to)
ex t a v1nZ eddreew 74 V 4 40 4 4` �' �f # ''54'
(Address where work will be performed)
•
The nature of the work =Mots of : (Cheek One or Datcrthe the Neturo of Work)
J"C Recormectian or now circuit fog place men Fta or NC •
Resection or new circuit for rep Lacam at'itr iltter Beater.
Reconnection of the Service Entrance Coble. Meow Box, oltoratione to - • _ • god
lighting 5xturea due to siding r sank installation. Note: Now • . .
Cables will require a wrote pami&
Recourcsulon or new circuit for other permanently wired appliances l $atinee.
Other
•
The value of this work is S Ate
I hereby verify this work will be perf by an employee of Ws company and further verily
reconnection t installation will be done in compliance with metudeotnrer and Electric code
requirenter s.
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