HomeMy WebLinkAbout0102172-HVAC (furnace & chimney)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2005 WHITE SWAN DR Owner JAMES J HAYDOCK
Contractor WESLEY HEATING & COOLING INC Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas J ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m btu
No
Create Date
Plan
~J Solid
Vent
102172
06/13/2003
Use/Nature SFR/Install furnace and chimney liner. *EIV form from Solar Electric.
of Work
Fees: Valuation
Issued By:
$4,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$68.00
Date 06/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1736 SAL STREET GREEN BAY WI 54302 -0
Telephone Number
(920) 468-6951/235-6
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
O~Nko~, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-$084
Ill-lC OSH 2.35-'7550 p. :2
H'.'
Incomplete applkation~ will not b~ procesS.
Apptie~ti_on(a) and fee(s) can be brought to City Hail, Room 205 or mailed Io Inspection Services, PO Box t I28,
Oshkosh WI 54903-1 ~28. Corm-nexacing work wilhoat permit(s) wilt re~mlt in fees being doub__ted or $100,00 plus the
normal permit fee, which ever is greater.
OR
!~you are tt contractor par. ticipatin~_in.the Permit. fee dccoun! S.~.st.em and have adequa, te )Cunds,_.check her~e
i~¥Ou want th~s pr.o¢.ess~.d through Vou.r ~CCour, t !~
DATE
CHECK ~I ALL APPLICABLE
Ub-SE CATEGORY
~n3ingte Family EIDuplex
IZIMutfi -Family F1Remal
FUEL ~tTGas .1ZIElec~ic Ulgolid SYSTEM ElNew
EIOil EISolar ClO~er
Ctlndustriat
TYPE
~ijForeed Air EfRadiant EISteam EIMC ElVent EIEIecMc Elliot Water ElSuppl. 13Con. Burner
ISCttlM'NEYBEmGL~mNo~-LltqERSIZE 3" aMANLiFAC~~Li~X/LJ/sj~p-~
Note: Alt cat~mmey~ shall be ~ per the BTU s being vented;
CHIMNEY 'TYI'E glChirrmey A E]Chimne¥ B '~Direct Vent OOth~r
HEAT LOSS FIAs Approved ~Existin~ ONot Applicable
DESC~ON .OF ALL WORK BErG DONE
VALUE Onemding labor and all materials including light fixtures) $ 5/ oR .00. CO O ~. DO
. L CTPaCaX co mncroa SRO/.
~8~For applicable projects, an Electric Installation Verification form, signed by the Elec~ieat Contractor, must be
attacked. If not attached or nor applicable, a separate Electrical Permit is required,
,.]un 05 03 '1 !: 33a kIHC
235 -?550
Solar £1ec~rlc
~leetric laflallat~n Verification