HomeMy WebLinkAbout0084440-HVAC (boiler) C i CITY OF OSHKOSH N 84440
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1312 MINNESOTA ST Owner RICHARD H DEMLER Create Date 02/27/2001
Contractor MARX HEATING & A/C INC Category 500 - Residential- Heating & Ventilating Plan
Fuel VI Gas Od ] Electric 1 Solar Solid
System N eN w 7
Other 1
Forced Air Radiant ' A/C ' Vent
Electric ✓ Hot Water Suppl. Con. Burner
Chimney Type ( ) Chimney A ( Chimney B ( ) Direct Vent ( ) Not Applicable
Heat Loss ( ) As Approved 0 Existing ( ) Not Applicable Value
BTU Rate ' ) As Per Plan ( ) Variable ( ) Other Value
Use /Nature SFR / REPLACE BOILER WI I H WEILMCLAIN CG -5
of Work (No electric permit required- received installation verification signed by Van Ert Electric)
Fees: Valuation $2,336.00 Plan Approval $0.00 Permit Fee Paid $39.50
Issued By: 5� Date 02/27/2001
ETP 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 4535 STATE ROAD 91 OSHKOSH WI 54904 - 9244 Telephone Number (920) 235 -6510
3 /.5D
(;;) Division of Inspection Services
215 Church Avenue
P.O. Box 1130
t jV,1 gg - Os WI 54903 -1130
Fax # (920) 236 -5084
ON THE WA ER
Phone (920) 236 - 5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 0) O I
JOB ADDRESS '3 I oI I _
rr I i 0I1
OWNER I C U De M L C
CONTRACTOR r -X N _ ca k tC c
CIRCLE ALL APPLICABLE
USE CATEGORY INGLE FAMIL DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW ( PLACE OTHER
TYPE FORCED AIR RADIANT STEAM A/C VENT
ELECTRIC HOT WAT SUPPL. CON. BURNER
IS CHIMNEY BEING LINED N 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 (EXISTING___) NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK: E bO1 f L 1 n C1AA � L RC J\ l A, C6--5
VALUE (Including labor and materials) $ A336, 00
ELECTRICAL CONTRACTOR
\jiAt v eP T E t yZLCJ Co
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$ 0 t o $1, 0 0 0 .0 0 .._.»._.»._.»._._._.»....»._._...._...»»..._._._.».»._._._.......». _». ».......... ». »._...._._._..$ 2 0 .0 0
$1,000.01 to $10,000.00 ....... _ .... ._._......._._ .». »._. »...._._._._..._._. ». ».. .0 0 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 ..... ...... . for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over$25, 0 0 0.0 0 .._ _».._._._.»._...._....._.»._._.».».»...._.».».»._».».».. .._._ »._._. »._...._.._. »._._._. plus $0.50
per $100.00 valuation or part thereof
Av 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.