HomeMy WebLinkAbout0101393 HOSHKOSH
ON THE WATER
.lob Address 1270 PHEASANT CREEK DR
Contractor CONDON TOTAL COMFORT
Fuel
System
Gas
New
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner RUSCH HOMES
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101393
05/09/2003
Other
Vent J
Use/Nature SFR/Install 2T a/c system.
of Work
Fees: Valuation
Issued By:
$1,375.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$26.00
Date 05/09/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 11 BLACKBURN ST RIPON WI 54971 - 184 Telephone Number
(920) 748-5050
Fax¢(~20).236=$084 ,.-. ,-...:?:..
.' '.2i.' ": ~ . ~.' ... '.o'
HVAC PERMIT APPLICATION
All information after bold categories rmmt be provided.
Incomplete applicafion~ will not be processed.
· 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 dbubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I ou are a contractor artici atin in'the Permi, r ............ s
" , ~ ,accounto stem ananave ade uate unds check here
i ou want this rocessed throu h our account
JOB ADDRESS
ow .
I. ;
Cl~.CK [] ALL APPLICABLE
U~;E CATEGORY
~[~ingle Family l-lDuplex
[3Multi-Family F-IRental
F1Commercial
[3Industrial
FUEL UIGas [3Electric [3Solid SYSTEM ~ew FIReplace
FIOil UISolar / l-IOther
TYPE
F'lForced Air UIRadiant FISteam/~A/C FIVent [3Electric F1Hot Water lDSuppl. FICon. Bm'ncr
IS CHIMNEY BEING LINED [3No r-l, Ye~ ---v-L-INER SIZE & MANUFAC'I2JRER
Note: All ch/mneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
l-lChimney A [2]Chimney B ~D~_~.ix. ect~ent ~Cn-her
IDAs Approved
~, _~E~Not Applicable
12] A s~ P e r-PAan'--'"'~l-I V an a b le "
F-lOt. her Value
DESCRIPTION OF ALL WORK BEING DONE
VAI,IIE (h, ch, ding labor and all materials induding light fixtures) [,__~_~.....~. .
i':[,E("I'RI('AI, (;()N'I'RA('T()R~ ()~ { } Electric Installation Verification form altnched(If Rcplncen~nt)