HomeMy WebLinkAbout0102472 HOSHKOSH
ON THE WATER
.lob Address 248 W SOUTH PARKAVE
Contractor MARX MECHANICAL
Fuel
System
Gas J ~J Oil
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner JAMES L LEROY
Category 502- Residential-Both
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
102472
06/27/2003
Other J
Vent J
Use/Nature SFR/Replace furnace and 3 ton A/C.
of Work
Fees: Valuation
Issued By:
$4,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$68.00
Date 06/27/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number
(920) 235-6510
City of Oshkosh
Division of Inspection Service~
P.O. Box 1 !30
Oshkosh, WI 54903}1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
(f you want this processed through your account
JOB ADDRESS
CONT~CTOR k~gg~X- ¢q~444~CPrC lk~G
CItECK [] ALL APPLICABLE
F1Multi-Family
F1Rental
USE CATEGORY
l~ISingle Fmnily F1Duplex
FUEL mas F1Electric DSolid SYSTEM
F'lOil F1Solar
[2New [~,Replace
IDOther
TYPE
~Forced Air IDRadiant IqSteam IXlA/C F1Vent F1Electric
IS CHIMNEY BEING LINED U]No I~Yes - LINER SIZE ,~"
Note: All chimneys shall be sized per the BTU's being vented.
E]Hot Water [qSuppl. F1Con. Burner
& MANUFACTURER
CHIMNEY TYPE F1Chimney A nChimney B IqDirect Vent
HEAT LOSS []]As Approved F1Existing DNot Applicable
BTU RATE ElAs Per Plan nVariable F1Other Value
~)ESCmeTION Or ALL WOaX BEING ~ONE ¢~N<f '~
nOther
VALUE (Including labor and all materials including light fixtures) $ q{~4.)O oo
ELECTRICAL CONTRACTOR ~ 0kJ, J~
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02