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CITY OF OSHKOSH No 0076333
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3193 BELLFIELD DR Owner RUSCH HOMES Create Date 01/27/2000
Contractor BREWER HEATING Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas Od Electric Solar Solid
System ✓ New Replace I Other
Forced Air O Radiant , A Steam O A/C L Vent
Electric I Hot Water I Suppl. I Con. Burner
Chimney Type ' ) Chimney A () Chimney B • Direct Vent () Not Applicable I
Heat Loss ' ) As Approved ( ) Existing O Not Applicable Value
BTU Rate \ ) As Per Plan O Variable 0 Other I Value
Use /Nature INS I ALL NEW FURNACE
of Work
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $35.00
Issued By: Date 04/10/2000
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 N8804 N DOUGLAS ST RIPON WI 54971 -0 Telephone Number 1- 748 -6494