HomeMy WebLinkAbout092116 - HVAC (gas furnace) 10 CITY OF OSHKOSH No 92116
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2111 MOUNT VERNON ST Owner THOMAS N RUSCH Create Date 07/26/2001
Contractor CONDON TOTAL COMFORT Category 500-Residential-Heating&Ventilating Plan
Fuel 1 1 Gas 1 Oil Electric i Solar I rSolid 71
System E New Replace i 0 Other
j Forced Air J Radiant J Steam J A/C J Vent
Electric Hot Water Suppl. Con.Burner
Chimney Type U Chimney A • Chimney B O Direct Vent O Not Applicable
Heat Loss As Approved O Existing • Not Applicable Value
BTU Rate As Per Plan O Variable J Other Value 60M BTU
Use/Nature NSFR/INSTALL GAS FURNACE
of Work
Fees: Valuation $3,050.00 Plan Approval $0.00 Permit Fee Paid $51.50
Issued By: la y\\ Date 01/08/2002
[�'' J Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 11 BLACKBURN ST RIPON WI 54971 -184 Telephone Number (920)748-5050
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HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE /— 4-).k
OB ADDRESS /// (L-11.-n,r�
WNER ' :a_ki, 0-ht-Q- -4/ d -, i
ONTRACTOR r A 1, a,,16..tom . •
IRCLE ALL APPL /
3E CATEGORY N�FAMILY DUPLEX MULTI-FAMILY COMMERCIAL INDUSTRIAL
OHL 4=15) OIL ELECTRIC SOLAR SOLID
fSTEH REPLACE OTHER
fPE FORCED AI_R ) RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
3 ( iXY BEING LINED - LINER SIZE MANUFACTURER -
)te$ All chimneys shall be sized per the B
vented.
.
'BE TYPE -CHIHQEY t r, B • DIRECT V T• '' OTHER
BAT LOSS • AS APPROVED EXISTING NOT APPLICABLE
ru RATE AS PER PLAN VARIABLE • OTHER VALUE l p f.4-t) tI 6t
PTURE OF WORK: /
kI.UE (Including labor and materials) $ .020TT/) __
:.ECTRICAL CONTRACTOR �(
..ectrical installation of new/replacement equipment shall be done by licensed
>ntractors.
iluation Fees
to $1,000.00 $20.00
L,000.01 to $10,000.00 _.-__.___„__$20.00 for first
$1,000.00 plus $1.50 per $100 . 00 valuation or part thereof
t 0, 000.01 to $25,000.00._._._._._.__. • ' « ..$155.00 for first
$10,000.00 plus $1.00 per $100.. 00 valuation or part thereof
_._._...._......._._._._._._._._............._._. ........$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.