HomeMy WebLinkAbout0102519 HOSHKOSH
ON THE WATER
.lob Address 60 JACOB AVE
Contractor OWNER
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner JOSEPH M/SHANNO REPKA
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
102519
06/30/2003
Other
Vent J
Use/Nature
of Work
Gas Fireplace in Basement Family Room.
Fees: Valuation
Issued By:
$500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 06/30/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 60 JACOB AVE OSHKOSH WI 54902 -0
Telephone Number
OSHKOSH
ON THE WATER
Job Address 60 JACOB AVE
Contractor OWNER
Fuel L~J Gas
System [] New
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
[__J Forced Air
[J Electric
Owner JOSEPH M/SHANNO REPKA
Category 500 - Residential-Heating & Ventilating
Oil I I I Electric
[] Replace
Radiant I [~ Steam
Hot Water I I I Suppl.
~--Solar
~ Nc
~-Con. Burner
Chimney Type O Chimney A O Chimney B ~ Direct Vent O Not Applicable
Heat Loss ~ As Approved ~ Existing ~11 Not Applicable
BTU Rate ~ As Per Plan (..~ Variable ~ Other
Value
Value
No 102519
Create Date 06/30/2003
Plan
~ I Solid
[] Other
Vent
Use/Nature nstall Gas Fireplace in Basement Family Room.
of Work
Valuation0
Fees: .
Issued By:
Plan Approval $0.00 Permit Fee Paid
[] Permit Voided
$20.00
Date 06/30/2003
In the performance o~' work, I ag~ll work pursuant to rules governing the described construction.
Signature ~...,,~
Agent/Owner
Address 60 JACOB AVE OSHKOSH WI 54902 -0 Telephone Number