HomeMy WebLinkAbout0100504-HVACOSHKOSH
ON THE WATER
.lob Address 2451 N MAIN ST
Contractor K KELLY INC
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner SKB CAPITAL CORPORATION
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate IO As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100504
03/24/2003
Other J
Vent J
Use/Nature
of Work
12 UNIT/Install Hydronic heating system.
Fees: Valuation
Issued By:
$21,787.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$273.00
Date 03/28/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2057 BELLEVUE ST GREEN BAY WI 54311 -5619 Telephone Number
877-905-3559/920-46
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-$050
Fax (920) 236-50114
Oshkosh Inspections
920-236-5084
.v^c
Alt information after bold catego~es m~t be provided.
~cow~lete a~licado~ will not be processed.
p.2
Application(s) and tee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO l~ox 1 t28,
Oshkosh WI 54903-1128. Co~cing work without permit(s) will result in fees b~ing doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating .in the Permit fee ,~ccount System and have ~dequate funds, check here
if you ~vant this processed through your account n']
CHECK ~ ALL APPLICABLE
USE CATEGORY
UISingte Family IZIDuplex j~vfulti-Family
IDRental IZICommercial Ellndustrial
FUEL XGas ElElectric nSolid SYSTEM. J2l~q'ew
[DOil DSolar [3Other
[3Replace
TYPE
ElForced Air DRadiant F1Steam IDA/C FIVent IZIElectric .~ot Water FiSuppl.
IS cmm y Bmnc Ln, mD aNo rny s - LImm St2 ,A///0C & . crumm
Note: All chimneys shall be sized per the BTU's being vented.
CRIMiNEY TYPE DChimey A ~'himey B rnDirect Vent E3Other
HEAT LOSS IZlAs Approved ElExisting ~Not Applicable
BTU RATE J~As Per Plan [3Variable DOther Value
DESCRIPTION OF ALL WORK BEING DON~E
·
EICon. Burner
ELECTRICAL CONTRACTOR
[] F°r 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.