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HomeMy WebLinkAbout0095622-HVAC (a/c) l CITY OF OSHKOSH No 95622 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 3112 BELLFIELD DR Owner MATTHEW J /SARAH DEMMIN Create Date 07/02/2002 Contractor CONDON TOTAL COMFORT Category 501 - Residential -Air Conditioning Plan Fuel 1 1 Gas 1 Oil I Electric Solar 1 Solid System 0 New n Replace I ❑ Other ❑ Forced Air _J Radiant Li Steam u NC Li Vent Electric 1 Hot Water 1 Suppl. I Con. Bumer Chimney Type 0 Chimney A ❑ Chimney B ❑ Direct Vent 0 Not Applicable Heat Loss `) As Approved ❑ Existing • Not Applicable Value 0 BTU Rate ; ) As Per Plan C) Variable • Other Value Use /Nature SFR/ Install new 1.5 ton a/c system. of Work Fees: Valuation $1,340.00 Plan Approval $0.00 Permit Fee Paid $26.00 Issued By: k Date 07/02/2002 ❑ Permit Voided In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 11 BLACKBURN ST RIPON WI 54971 -184 Telephone Number (920) 748 -5050 .City Oshkosh - Ditisionoonspect on Services. , 141 c, 130 ,•' . " - ,101.! Zr �.. O$hkosb,-Wl 54903- 1130 Phone (920) 236- 5050 " 1*c:420)= 364084 < ` – Da= ON THE WATER HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. • Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903 -1128. 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 area contractor participating in the Permit fee Account System and have adequate funds. check here if you want this processed through your account n DATE ' <A' �. JOB ADDRESS i / / / ) L 1 ) OWNER L u ba / ,l CONTRACTOR l ',(,,, , CHECK Q ALL APPLICABLE E CATEGORY Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑industrial FUEL ❑Gas ❑Electric ❑Solid SYSTEM AliNew ❑Replace ❑Oil ❑Solar ❑Oth TYPE ❑Forced Air ❑Radiant ❑SteamXA/C OVent ❑Electric ❑Hot Water ❑Suppl. ❑Con. Burner IS CHIMNEY BEING LINED)iNo ❑Yes - 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 DAs Approved ❑Existing ❑Not Applicable BTU RATE DAs Per Plan ❑Variable ❑Other Value DESCRIPTION OF ALL WORK BEING DONE / T 44 VALUE (Including labor and all materials including light fixtures) $ /090 — ELECTRICAL CONTRACTOR.. OR ❑ Electric Installation Verification form attached(If Replacement) Electrical installation of new /replacement equipment shall be done by licensed contractors. 3/02