HomeMy WebLinkAbout0101098 HOSHKOSH
ON THE WATER
.lob Address 1843 OHIO ST
Contractor OWNER
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner MICHAEL R DREXLER
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101098
04/29/2003
Other
Vent J
Use/Nature SFR/Repalce gas furnace and install new central ar.
of Work
Fees: Valuation
Issued By:
$1,500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$27.50
Date 04/29/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address OSHKOSH WI 54901 -0
Telephone Number
OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1843 OHIO ST
OWNER
~- Gas [ [] Oil
[] _N~ ............ i
~d Forced Air i L~ Radiant
E~Electric I E~ Hot Water ]
Chimney Type ~I Chimney A ~ Chimney B
Heat Loss ~ As Approved ~ Existing
BTU Rate ~ As Per Plan ~ Variable
Use/Nature SFR/Repalce gas furnace and install new central air.
Owner MICHAEL R DREXLER
Category 502- Residential-Both
L_J Electric I
[] Replace ~
L-J Steam
[] S.ppl.
(_~ Direct Vent
Not Applicable
Other
[] Solar
LJ Nc
L~ Con. Burner
Not Applicable
Value
Value
No 101098
Create Date 04/29/2003
Plan
I E~-~lid 1
[] Other I
Vent J
of Work
Fees: Valuation
Issued By: ~
$1,500.00 Plan Approval
$0.00
Permit Fee Paid
[] Permit Voided
$27.50
Date 04/29/2003
SignatureIn the performance of thi¢ w, grk, ,~,~~ I agree to ~.,~o~l~es ' -"-~e n t/~wn e-~"-
_os os,
governing the described construction.
Date
WI 54901 -0 Telephone Number
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
· 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 funds, check here
if you want this processed through your account
CONTRACTOR
DATE
CHECK I~I ALL APPLICABLE
USE CATEGORY
~l~ingle Family F1Duplex
I-IMulti-Family
[:]Rental mCommercial IZllndustrial
FUEL l~Gas F1Electric F1Solid SYSTEM F1New ~eplace
I-1Oil FISolar mOther
ced Air F1Radiant FISteam []A/C []Vent FIElectric F1Hot Water F1Suppl. FICon. Burner
IS CHIMNEY BEING LINED 12t~o FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE q~Chimney A []Chimney B []Direct Vent F1Other
HEAT LOSS nAs Approved F1Existing []Not Applicable
BTU RATE []As Per Plan [-IVariable []Other Value
DESCRIPTION OF ALL WORK BEING DONE ¢~,.,r-~(~td~fL~,Cve~ C
VALUE (Including labor and all materials including light f'~xtures) $ I~ 0~'~)0
ELECTRICAL CONTRACTOR ~ JC ~XC~fL-
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02