HomeMy WebLinkAbout0086128-HVAC E
' �
� CITY OF OSHKOSH No ss�zs
� f
3
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2800 NEWPORT AVE Owner RUSCH HOMES Create Date 03/14/2001 �
t
Contractor CONDON TOTAL COMFORT Category 502-Residential-Both Plan �
Fuel ✓ Gas Oil Electric Solar Solid� �
E
System �✓ New I � Replace � Q Other I 4
✓ Forced Air �Radiant Steam ✓ A/C Vent �
�
Electric Hot Water Suppl. Con.Burner r
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
t
BTU Rate As Per Plan Variable Other Value s
�
Use/Nature SFR/INSTALL NEW 60,000 BTU GAS FURNACE AND NEW 2-1/2 TON A/C SYSTEM
of Work
�
;
Fees: Valua' $4,800.00 Plan Approval $0.00 Permit Fee Paid $77.00
Issued By: Date 05/18/2001
� Permit Voided I
In the performance of this work, I agree to perforrn all work pursuant to rules governing the described construction.
i
Signature Date '
«
AgenUOwner �
Address 11 BLACKBURN ST RIPON WI 54971 -0 Telephone Number (920)748-3186
;
€
�
�
k
E
1
�
�
� Divi�iou o! In�pection Services
� 115 Church 1lveaue
P.O. Box 1130
� Oahkosh, MI S{903-1130
Fax � (920) 236-508{
Phone (920) 236-5048
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATB � Q
JOB ADDRS88 ��� � �
/ .
OWNSR ���c2.�Lhr �.,�k 4,�2�
CONTRACTOR (;,.1�C w r .P , �^ �7�. .
CIRCL$ ALL APPLICABL$
IISB CATBQORY SINGLE FAMILY � DUPLEX MULTI-FAMILY COMMERCIAL INDUSTRIAL
FIIBL GAS OIL ELECTRIC SOLAR SOLID
SYSTffirI � NEW REPLACE OTHER
TYPB FORCED AIR RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
. . ., .
IS CSIbIIdBY BBIN(3 LINBD LINER SIZE MANUFACTURER ��"
Note: All chimneys shall be sized per the BTU's being vented.
�I�� �$ CHINIIJEY A CHIIrINFY B � D T OTHfiR
HSAT L033 AS APPROVED EXISTING NOT APPLICABLE
BTU RATB AS PER PLAN VARIABLE OTHER VALUE D� O�-�>-c7 �
rrA� oF woxx:�.��-��_ C�l�..�5.'-.,�-n�,.- 6 0. � �r�a� � �>� :
- 0 �--,�-�-•,..._ �.S T ���. � �
�` ���
VALII$ (Including labor and materials) $ r��. �—
BLHCTRICAL CONTRACTOR c�L,
Electrical installation of new/replacement equipment ahall 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 rs 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.......••......................._._._._......._.........._................--•_._.........._..........•--•••_._..............$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.