HomeMy WebLinkAbout0100505 HOSHKOSH
ON THE WATER
.lob Address 2461 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
100505
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
Hat 06 03 03:3~p
City ot O~koah
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phoae (920) 236-5050
Fax (920) 236-$084
Oshkosh InspectionS~EcE.~V~~S
OE.I::,ARTI E T OF
HVAC PERMIT APPLICATION
All information a~ter bold categories must be provided.
Incomplete applications will not be proe~sed.
· Application(s) and fee(s) can be brought to City Hail, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1 t28. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor partictt~ating in the Permit fee ,~ccount System and have ~tdcauate funds, check here
~f Vou want thi~ processed through v~tr aCCOUnt ~
2 ,./?. I AL mn/ ? ,5-M
CBECK ti~ ALL APPLICABLE
USE CATEGORY
EISingle Family rlDuplex ~ulti-Family
lZtRentat IZtComm~cial rqIndustrial
FUEL EIC_ras ElElcctric I-lSolid SYSTEM eJ~jr[~t ~ fireplace
DOff nSolar ' I~Oth ~r
TYPE
E)Foreed Air ORadiant OSteam r'lMC OVont ElElectri¢
IS ~Y BEING ~ IEINo OYes
Note: All chimneys shall be sized per the BTU'$ being vented.
fl~Hot Water DSuppl.
&-MANUFACTURER
CHIMNEY TYPE r'lChimney A ~ey B r'lDireet Vent o-lOt, her
HEAT LOSS OAs Approved OExi~g fl~Not Applicable
BTU RATE ,~As Per Plan OVariable ElOth~ Value
OCon. Burner
ELECTRICAL CONTRACTOR
D For applicable projects, an Eleelric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical ?ea-aiit is required.