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HomeMy WebLinkAbout0101164-HVAC (boiler)(~ CITY OF OSHKOSH OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1623 EVANS ST Owner NORBERT J METZEN Contractor WESLEY HEATING & COOLING INC Category 500 - Residential-Heating & Ventilating Fuel ~J Gas J ~J Oil b~ Electric ~J Solar System ~J New ~ ~J Replace ~ ~J Other ~J Forced Air I ~J Radiant L~ Steam ~J A/C ~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner Chimney Type I~ Chimney A O Chimney B ~ Direct Vent ~ Not Applicable I Heat Loss I~ As Approved O Existing ~ Not Applicable I Value BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75M BTU No Create Date Plan ~J Solid Vent 101164 05/01/2003 Use/Nature SFR/Replace existing boiler with a Lennox boiler. *EIV form from Solar Electric. of Work Fees: Valuation Issued By: $2,800.00 Plan Approval $0.00 Permit Fee Paid Permit Voided $47.00 Date 05/01/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1736 SAL STREET GREEN BAY WI 54302 -0 Telephone Number (920) 468-6951/235-6 ~pr 1,~ 03 08:31a ~HC OSH 235-?$50 City of Oshkosh Division of Inspection Services P.O. Box I t 30 Oshkosh,. WI 54903-i t30 Phone (920) 236-5050 Fax (920) 236-5084 HVAC PERMIT APPLICATION All information after bold eal~gories mugt Iae provided. Incomplete applications will not be processed. Application(s) and fee(s) eat: be brought to City Hall, Room 205 or mailed to Inspection ierdces, PO Box 1128, Oshkosh WI 54903-! 128. Commencing work without permit(s) will result in fees b~ing doubled or $100.00 plus the normal permit fee, which ever is greater: OR. ~yOtt are a contractor partic, ipating in the permit fee Account System and. have adequate funds, check her_e if Y°u want this processed through your account []DATE /~/'v~ t / 0a~ COtVrRACYrOR {,qff5 t-~cY usz O~rzgo~x ~Sin~e Family DDuplex RECEIVED PlAY 0 1 2003 IZlMulti-Family ElRental FUEL .lS]Gas DE]ectric EtSolid SYSTEM ~New ~eplace il VISolar IZIOther IZtForced Air l-tRadiant IZ1Steam OMC t-lVent ClFAeetric t Water !21Suppl,OCon. Burner IS CHI3qlNE¥ BEENG LINED ~l~4o OYes - LINER SIZE ' & MANLVFA~~ Note: Ail chimneys shall be sized per Ixhe BTU's bffnvg ye.ri_Lc.d, CFIIMNEY TYPE HEAT LOSS BTU RATE [2tChinmey A ,~.hirrmey B ElDireet V~t IDOther I-lAs Approved ~xisting l'lNot Applicable E1As Pex Plan IZlVariable El~)ther Value __ ~,ESCVamO-~ or azL wo~ ~ExxO ~)O.~_ ~ VALIJE (Including labor and all materials including light fixtures) ELECTRICAL CONTRACTOR.. O__~ ~ £1e~trie lm~tallali~n Verification f~rm Itlllch~l(lfR~pl:cem~a~) El '~caf installation of newZ. eplacement eqMprnent sPm!l be. done by ficer~ed contract, 04/~7/03 14:D$ FAX 920 238 ~C E~VED MAY 0 1