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HomeMy WebLinkAbout0102412 HOSHKOSH ON THE WATER .lob Address 505 N WESTFIELD ST Contractor PALISADES SHEET METAL Fuel System Gas J ~J Oil New ~ Forced Air Electric CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Radiant Hot Water Owner MICHAEL J MCCLONE Category 500- Residential-Heating & Ventilating 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 102412 06/24/2003 Other J Vent J Use/Nature COMM/Replace furnace. of Work Fees: Valuation Issued By: $4,600.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $74.00 Date 06/24/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1475 RACINE ROAD MENASHA WI 54952 -0 Telephone Number (920) 729-1282  Division of Inspection Services 215 Church Avenue P.O. Box 1130  Oshkosh, WI 54903-1130 ~-~ Fax # (920) 236-5084 ~ ~ Phone (920) 236-5048 JUN 3 HVAC PERMIT AppLICATION A s must be RTMENT OF Ail fields/information after bold categorie tq~Q¥~ ....... $ m,,, Incomplete applications Will not be processed~Y~J~%~V~0~¥ D~u~' '""~ JOB ADDRESS OWNER 505 N Westfield McC16ne Agency CONTRACTOR Palisades Sheet Metal CIRCLE ALL APPLICABLE USE CATEGORY SINGLE FAMILY DUPLEX FUEL ~ OIL ELECTRIC SYSTEM NEW ~ TYPE ~~ED ~IR~ RADIANT ELECTRIC HOT WATER DATE MULTI-FAMILY ~M INDUSTRIAL SOLAR ~ID OTHER STEAM A/C SUPPL. IS CHIMNEY BEING LINED LINER SIZE ~JLNI3FACTURER ore: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE · CHIMNEY A CHIMNEY B DIRECT VENT OTHER HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE VENT CON. BURNER BTU RATE AS PER PLAN VARIABLE OTHER VALUE NATURE OF WORK:  and materials) contractors . Valuation Fees $0 to $1,000.00 ................................................................................................................................ $20.00 $1,000.01 to $10,000.00 ......................................................................................................... $20.00 for first $1,000.00 plus $1.50 per $100.00 valuation or part thereof $10,000.01 to $25,000.00 ................................................ ,,.....i ................................................. $155.00 for first $10,000.00 plus $1.00 per $100.00 valuationor part thereof Over $25,000.00 ........................................... [ .................................................. r.~.,.~ .............. ,~, ............. $305.00 plus $0.50 ,/~-~' ' ~ :: per $100.00 valua~ioh or p~rt thereof · Submit' paymen~ wit~i~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.