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HomeMy WebLinkAbout0084081-HVAC C CITY OF OSHKOSH N 84081 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2017 SHERIDAN ST Owner FLOYD M PROCTOR Create Date 10/12/2000 Contractor TENTH STREET STATION INC Category 500 - Residential- Heating & Ventilating Plan Fuel I ✓1 Gas 011 Electric Solar Solid System ✓ New Replace Other VI Forced Air Radiant Steam A/C I Vent Electric Hot Water Suppl. Con. Burner Chimney Type = ) Chimney A ( ) Chimney B • Direct Vent O Not Applicable Heat Loss \) As Approved 0 Existing O Not Applicable Value BTU Rate ) As Per Plan ( ) Variable • Other Value 75,000 Use /Nature SFR / REPLACE SPACE HEATERS WI (H 90+ DIRECT VENTAND DUCT SYSTEM of Work Fees: Valuation $3,756.36 Plan Approval $0.00 Permit Fee Paid $62.00 Issued By: 3 Date 02/06/2001 J 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 924 OHIO STREET OSHKOSH WI 54902 -0 Telephone Number 236 -8770, MOBILE ED Division of Inspection Services 215 Church Avenue P.O. Box 1130 0.IHKO1H Oshkosh, W 5 4903 -1130 ON THE WATER Fax # (920) 236 -5084 Phone (920) 236 -5048 HVAC PERMIT APPLICATION All fields /information after bold categories must be provided. Incomplete applications will not be processed. DATE OA i JOB ADDRESS 2 0 1 S H7.-- b ii--Al OWNER Jt7F 0q9-(4.567A/ CONTRACTOR Wit 57/26- 574 Z IN' • . CIRCLE ALL APPLICABLE USE CATEGORY SINGLE FAMI DUPLEX MULTI - FAMILY COMMERCIAL INDUSTRIAL FUEL OIL ELECTRIC SOLAR SOLID SYSTEM EW REPLACE OTHER TYPE F ORCED AIR RADIANT STEAM A/C VENT ELECTRIC HOT WATER SUPPL. CON. BURNER IS CHIMNEY BEING LINED 440. LINER SIZE MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented.' CHIMNEY TYPE CHIMNEY A CHIMNEY B CIRECT VENT OTHER HEAT LOSS AS APPROVED XISTING NOT APPLICABLE BTU RATE AS PER PLAN VARIABLE OTHER VALUE 7, NATURE OF WORK: /,�2ee_ `! 5 4 4 / tS G✓I1Gt �V t-- e di r,P- �u av, e/ dPiv'- s p�t'-s'» ®® `l -' 42 06 VALUE (Including labor and materials) $3 756- 36 /1�� Aid" 60 — t ��J,3) e -SJ �„ ELECTRICAL CONTRACTOR ��r,Q ,6� � G / Electrical installation of ne / eplacement equipment shall be done by licensed 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.