HomeMy WebLinkAbout0086066-HVAC (a/c) 1 CITY OF OSHKOSH No 86066
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3759 GLENKIRK LN Owner Create Date 05/16/2001
Contractor MOBILE HOME STUFF STORE, INC. Category 501 - Residential -Air Conditioning Plan
Fuel ✓l Gas Oil Electric Solar Solid
System n New I ❑ Replace 0 Other
Forced Air u Radiant u Steam U A/C j Vent
Electric Hot Water I I Suppl. I Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 3 As Approved 0 Existing • Not Applicable Value
BTU Rate • As Per Plan 0 Variable 0 Other Value
Use /Nature SFR / INSTALL NEW 2 -1/2 TON A/C
of Work
Fees: Valuation $1,100.00 Plan Approval $0.00 Permit Fee Paid $21.50
Issued By: ` 4 n Date 05/16/2001
El 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 N6446 ROLLING MEADOWS DR FOND DU LAC WI 54937 - 0 Telephone Number (920) 923 -0098
May 08 01 08:51a Code Enforcement 920 -236 -5084 p.1
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WT 54903 -1130
w 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 6
JOB ADDRESS?/ 6' � � %Ai /c k&
OWNER Pa j Gt ( " l� U I S
CONTRACTOR fl' J I IcA1 nay , S I U - .S free. /../1(1
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLACE OTHER
TYPE FORCED AIR RADIANT STEAM A/C ) VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE 0�4- MANUFACTURER N ,
Note: All chimneys shall be sized per the BTU's bei g vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B 4 1001 1 11411110 OTHER
HEAT LOSS AS APPROVED EXISTING ■OT APPLICABLE
BTU RATE AS PER P VARIABLE OTHER VALUE
NATURE OF WORK: a L
5 - +on AC...)
VALUE (Including labor and materials) $ 1100•oO
ELECTRICAL CONTRACTOR DC Et dr `c
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation
Fees
$o to $1, 000. oo_.__ _._._._ _
$20
$1,000.01 to $10,000.00. _...° Sro ��.._. �"'.__.__._....__.__._ 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..___. _ _ ___....__ . 00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $ 2 5 , 0 0 0 $ 2 5 , 0 0 0 . 0 0 . _ _ _ _ _ - - - $ 3 0 5 . 0 .., _ ..„ .„ .... _ ...„._......__... ...... .......... »„....._ .,,. ,.._._ --$ 3 0 5 .0 0 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 $1.00.00 plus the normal permit fee, which ever is
greater.
05/08/01 08:01 TX /RX NO.6949 P.001