HomeMy WebLinkAbout0100956-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 610 E MELVIN AVE
Contractor CUSTOM HEATING & COOLING
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner THOMAS K LAFONTAINE
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss ]~ As Approved ~ Existing O Not Applicable ] Value
BTU Rate ]~ As Per Plan ~) Variable ~ Other ] Value
No
Create Date
Plan
L~ Solid
100956
04/23/2003
Other J
Vent J
Use/Nature SFR/Replace 40,000 btu furnace & ductwork. Replace central air - 18,000' EIV from Hoehne Electric attached.
of Work
Fees: Valuation
Issued By:
$4,080.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$66.50
Date 04/23/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1503 SOUTH MAIN STREET OSHKOSH WI 54902 -0
Telephone Number
(920) 235-7263
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON TH~ 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate fuxnds, check here
if you want this processed through vour account. ~ DATE '/'/~~~,~"
CHECK [] ALL APPLICABLE
US~_~ATEGORY
~Single Family 12Duplex nMulti-Family F1Rental
[2Commercial
Vllndustrial
FUEL l~"~as V1Electric V1Solid SYSTEM V1New i(1Keeplace
mOil VISolar []Other
~orced Air []Radiant V1Steam V1A/C I']Vent V1Electric []Hot Water F1Suppl. F1Con. Burner
IS CHIMNEY BEING LINED ENo ~ LINER SIZE ~ & MANUFACTURER
Note: All chimneys shall be sized per the BTU's behug vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[]Chimney A
r'lAs Approved
[]As Per Plan
[] Chimney B
[]Existing
[]Variable
[]Direct Vent
[]Not Applicable
[]Other Value
[]Other
· / d/'-c_J
VALUE (Including labor and all m~n,7,,~ing light fixtures)-$
ELECTRICAL CONTRACTOI~/~ OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02
O) (We)
(.Address)
(State) ' (z~p Code)
(~ wh~ ~# bperbmled)