HomeMy WebLinkAbout0101472-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
JobAddress 3737 GLENKIRK LN
Contractor MOBILE HOME STUFF STORE, INC.
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
~ Gas I
[] New
~_J Forced Air I [__J Radiant
Electric I ~] Hot Water
Owner JOSEPH ZIMMER
Category 502 - Residential-Both
M Electric
[] Replace
~ Steam
L~ suppl.
Solar
~ NC
[] Con. Burner
Chimney Type ~ ChimneyA ~.~ ChimneyB O DirectVent O Not Applicable
Heat Loss [~ As Approved ~ Existing O Not Applicable I Value
BTU Rate ~ As Per Plan ~.~ Variable ~ Other I Value
No 101472
Create Date 05/14/2003
Plan
[] Solid
[] Other
· b-J vent I
Use/Nature ;FP,/Install new a/c and replacement furnace.
of Work
Fees: Valuation
Issued By: ~_~b/~
$2,780.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided
$47.00
Date 05/14/2003
In the perfom~?ce of this work, I agree to perform alt work pursuant to rules governing the described construction.
Signature ~,., ~ (~(~;~'¢~ Agent/Owner
Address N6446 ROLLING MEADOWS DR FOND DU LAC WI 54937 - 0 Telephone Number (920) 923-0098
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
}IVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
SYSTEM~
TYPE ~ FOR~ RADIANT
MULTI - FAM I LY
SOLAR
OTHER
COMMERCIAL
ELECTRIC
SOLID
INDUSTRIAL
HOT WATER
STEAM ~ VENT
SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE
Note: Ail chimneys shall be sized per the BTU's being vented.
MANUFACTURER
CHIMNEY TYPE
CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS
AS APPROVED
EXISTING
NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE
OTHER VALUE
VALUE (Including labor a_nd materials)
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation
Fees
$0 to $1,000.00 ......................................................................................... $20.00
$1,000.01 to $10,000.00 ......................................................................... $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 ........................................................................ $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ........................................................................................... $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.