HomeMy WebLinkAbout0097791-HVAC (furnace) 0 CITY OF OSHKOSH No 97791
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1832 MINERVA ST Owner ARLENE V MUELLER Create Date 09/27/2002
Contractor CENTRAL HEATING SERVICE INC Category 510 - Ind. & Comm - Heating & Ventilating Plan
Fuel ✓ Gas Oil Electric 1 Solar I Solid 1
System 0 New 0 Replace El Other
121 Forced Air u Radiant U Steam u NC u Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type J Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss J As Approved () Existing • Not Applicable Value 0
BTU Rate 1) As Per Plan () Variable • Other Value
Use /Nature COMM/ Replace furnace. Late permit.
of Work
Fees: Valuation $1,810.00 Plan Approval $0.00 Permit Fee Paid $32.15
Issued By: KyvN Date 10/07/2002
D 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
0 Division of Inspection Services
215 Church Avenue
P.O. Box 1130
H
Oshkosh, WI 54903 -1130 RE CE/VED Fax # (920) 236 -5084
N WA P
Phone (920) 236 -5048
HVAC PERMIT APPLICATION OCT Q 4 2( 2
All fields /information after bold categories must be prRvided.
Incomplete applications will not be proce ��l, MT ENT OF
DATE 11 {{ll (( � I )' E � apM
JOB ADDRESS )' T ��
7
OWNER A 14 )2 0 )Q4 FA) / N L
l
CONTRACTOR C r 'A) - fQ A L H r- S t /L C. / !) c (V
. - QO
CIRCLE ALL APPLICABLE V
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY OMM6CIAL INDUSTRIAL
FUEL A OIL ELECTRIC SOLAR SOLID
SYSTEM NEW EPLACE OTHER
TYPE CED AIR RADIANT STEAM A/C 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 VENT OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK:
C H ANa 6 Fo eA) tot c E -,„„,,,..
VALUE (Including labor and materials) $ ? 1 U -
_ 3 `
ELECTRICAL CONTRACTOR 5 4A e F L E c_
Electrical installation of new /replacement equipment shall be done by licens- / //
contractors.
Valuation Fees
$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.
09/30/02 14:16 FAX 920 236 7725 Solar Electric ri101
•
•
city of Oshkosh
Division oflnspeed= Services
215 Church Avenue
PO Box 1130
Oshkosh Wi 54902-1130
Once 920 - 23-3050
ON TH4 WATLR Fax 920 -23 -508
Electric Installation Verification
(1) (We) / G am" 'd' 2:h r
3 c/q3 f (EElectrical Contractor Name) _ ,/ ICJ e l
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for C esi7 4 in . r #4111110., _..
(Name of party contracted to)
at the following address: / 6" 3 22r ,1/ ,ry)
,
(Address where work will be performed)
The nature of the work consists of : (Check One or Describe the Nature of Work)
t Reconnection or new circuit for replacement Heating Plant and/or A/C Condenses
A Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
lighting fixtures due to siding / soffit installation. Note: New Service En
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $ .
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in compliance with manufacturer and EIectric code
requirements.
11• - - . % A t le Ir j• ea 41
ign ' A r of Company Officer) {'F�rifit Name of Officer)