HomeMy WebLinkAbout2000-HVAC (a/c) .� �,
� CITY OF OSHKOSH No oosis�o
�
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 663 W 3RD AVE Owner STATE OF WISCONSIN Create Date 10/04/2000
Contractor MARX HEATING Category 511 -Ind.&Comm-Air Conditioning Plan
Fuel Gas Oil � ✓ Electric Solar -� Solid
System � New � � Repiace � � Other �
Forced Air Radiant Steam ✓ A/C Vent �
Electric Hot Water SuppL Con. Bumer
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature ational Guard!Replace carrier PTAC wali a/c unit
of Work
Fees: Valuation $998.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: ���� Date 10/04/2000
� Permit Voided � :
In the performance of this work,i agree to perform all work pursuant to rules goveming the described construction.
Signature Date
AgenUOwner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -9244 Telephone Number 235-6510
. . -� �
s
� Division of Inspection Services
� 215 Church Avenue
P.O. Box 1130
IHK IH Oshkosh. WI 54903-1130
Fax # (920) 236-5084
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Phone (920) 236-5048
HVAC PERNSIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE I � -�'��
JOB ADDRESS�QIQ� �►V ��1.%l �V�
o�R W I . NA���r� C uA�D
CONTRACTOR �'�/� t'�1 1 IV� `� �I�_ I r�3�
CIRCLE ALL APPLICABLE
*VS8 CF�TEGOP.Y �I.7^vLE FT-iI•iILY D'JFLEn I�IULTI-F'AitiIILY COIt/lb1ERC1� INTJUSIRIAL
FIIEL 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 BBING LINED LINER SIZE MANiJFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B DIRECT VEN OTHER
___
HBAT LOSS AS APPROVED EXISTING NOT APPLICABLE
�
BTII RATE AS PER PLAN VARIABLE OTHER VALUE
NATLJRB OF WORK: �\��T�C� I �h-�lC � P� �i-�"�� t� �
�C' �� li
VALIIE (Including labor and materials) $ Qq�, u�'
l3LBCTRICAL CONTRACTOR �I �
Electrical installation of�iew/replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 t o $1, 0 0 0 .0 0.._._._._._._._._._._._...._...._...._.........._...._...._�....._...�....._...._._._._._._._._._...._..$2 0 .0 0
$1, 0 0 0 .O 1 t o $10, 0 0 0 .0 0.._._._._._...._...._._._._._......._._.___.___._._.__._._._._...._...._._._..$2 0 .0 0 f or f i r s t
$1, 000 .00 plus $1.50 per $100 .00 valuation or part thereof
$10, 0 0 0 .O 1 t o $2 5, 0 0 0 .0 0....._._._......._.................._._...._.........._._._._._._.__._................_..$15 5 .0 0 f or f i rs t
$10, 000 . 00 plus $1.00 per $100 .00 valuation or part thereof
Over $2 5, 0 0 0 .0 0.._._..._...._...._...._.........._._._.......�......._._....__...._._._._....___.__.w......_...._._..$3 0 5.0 0 p lus $0 .5 0
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.