HomeMy WebLinkAbout0101559 HOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No 101559
1618 MENOMINEE DR
ZILLGES MATERIALS, INC.
L~ Gas I I~ oil
[] New I
Forced Air I ~ Radiant
U Electdc I ~j Hot Water
Owner
Category
RAYMOND/PAMELA KLASKE II
503 - STOVES AND FIREPLACES
L~ Electric I ~ Solar
[] Replace I
Steam I ~ A/C i
b~ suppl. I ~J Con. Burner
Chimney A ~ Chimney B ~ Direct Vent ~ Not Applicable
As Approved (..] Existing ~I Not Applicable I Value
As Per Plan ~.] Variable O Other I Value
Create Date 05/16/2003
Plan
~j Solid
[] Other
L~J Vent
22m
Use/Nature
of Work
IFR/Install direct vent gas fireplace.
Fees: Valuation
Issued By:
$1,735.35 Plan Approval $0.00 Permit Fee Paid
$32.00
Date 05/16/2003
[] Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1800 FOUNTAIN AVE OSHKOSH WI 54904 -0 Telephone Number
(920) 231-1994
P.0. BOx 1130
O
~hkosh, wi St903~1130
P~one (g~O~ 23¢-$0¢~
C~RCLE ALL APPLZCA~T~K
USE CAT~RY ~
~EL ~ OIL
SYST~ ~W
TYPE FORCED AIR
ELECTRIC
HVAC PERMIT APPLICATION
All fields/informa~ion after bold categories must be provided.
Incomplete applica~ions wi~l no= be processed.
DUPLEX
ELECTRIC
REPLAC~
RADIANT ..
~OTWAT~R
MULTI - FAMIL¥
OT~ER
STEAM
SUPPL.
COMMERCIA/~ INDUSTRIAL
SOLAR SOLID
A/C~ CON. BURNER
Ig CHIMNEY BEZNG LIITED LINER SI~E
Note: Ali chimneys shall be sized per the BTU's being vented.
CHZM~4~Y ~ZP~ CHIMNEY A
HEAT LOSS AS APPROVED
BT~ RATE AS PER PLAN
MANUFACTURER
C~IMNEy B D~~C~CT V~N_~T-~ OT~ER
EXISTING NOT APPLICABLE
VA~rASLE O~SR v~vE, ~3
VALUE (I~aluding labor and materials) $_ /7 ~ .~ ~ ~
~L~CT~.ICAL CO~rf~A~fOR.
Electrical insta~lation of new/replacemen~ equipment shall be done by licensed
contr~ctor~.
Valuation
Fees
si,ooo.o sio,0oo.0o_
~ , 0.00 plus $1.~0 per $100.00 valuation or part thereof
~lO,oO0.O0 plus $1.00 per $100.00 valuation or par~ thereof
~e~ ~2S,O00.O0 ............................................................................................ ~-..$305.00 plus $0.50
per $i00.00 valuation or part ~hereof
Submi~ pa~ent with ~pplica~ion. ~ailure zo pay within 30 days w~ll result in
fees being doubled or $100.00 plus ~he no~al permit fee, which e~er i~
greater.