HomeMy WebLinkAbout0101741 HOSHKOSH
ON THE WATER
,Job Address 516 W 18TH AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GRANT SCHULTZ HEATING & COOLING
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MICHAEL/LOIS NOONE
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101741
05/27/2003
Other
Vent J
Use/Nature SFR/Unico high velocity A/C system, infloor radiant heat.
of Work
Fees: Valuation
Issued By:
$18,250.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$238.00
Date 05/27/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1411 S MAIN ST Oshkosh WI 54902 - 6519 Telephone Number
(920) 216-1616
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920)'236-5050
Fax (920) 236-5084
O/HKO/H
ON THE LVATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Servi~ces, PO Box 1128,.
Oshkosh WI 54903-! 128. Commencing work without permit, s) will result in fees being doubled or St00.00 plus the
normal permit fee, which ever is greater~
OR
If you are a contractor participating in the Perm!t~e Account System and have adequate f~tnds, cheCk here
if You want this processed through your account
JOB ADD RES~
CONTRACTOR J ~~
CHECK [] ALL APPLICABLE
USE CATEGORY
~Single Family [3Duplex
[3Multi-Family
[3Rental [3Commercial I2Industrial
FUEL ~Gas [3Electric [3Solid SYSTEM l~New [3Replace
[3Oil [3Solar F1Other
TYPE
~Forced Air F1Radiant [3Steam ~[A/C [3Vent [3Electric F1Hot Water [3Suppl. F1Con. Burner
IS CHIMNEY BEING LINED [3No FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTLrRER
CHIMNEY TYPE [3Chimney A mChimney B gDirect Vent [3Other
HEAT LOSS F'lAs Approved [3Existing mNot Applicable
BTU RATE [3As Per Plan I'-lVariable F1Other Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $~ / ~ ~'~"~. ~
ELECTRICAL CONTRACTOR ~"~'//~?~" OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02