HomeMy WebLinkAbout0104736-HVAC (rebuild chimney/install liner)OSHKOSH
ON THE WATER
.lob Address 141 W 21ST AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
BLACK CAT CHIMNEY SERVICE & CONC
Oil
Owner TODD W/SANDRA J JOSEPH
Category 503- STOVES AND FIREPLACES
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
104736
10/13/2003
Other J
Vent J
130m btu
Use/Nature SFR/Tear down chimney to flashing and rebuild with new brick and concrete cap. Install UL listed and AGA accepted aluminum liner for gas
of Work furnace and water heater.
Fees: Valuation $1,640.00 Plan Approval $0.00 Permit Fee Paid $30.50
Issued By: Date 10/13/2003
Permit Voided J
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number
(920) 279-0197
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Inconrplete applications will not be processed.
O/HKO/H
· 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 erg is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
(f vou want this processed through your account [-]
$o ax ss /VI
/
CHECK I~ ALL APPLICABLE
USE CATEGORY
~Single Family F1Duplex I-1Multi-Family
[3Rental
DComm ci
[2Industrial
FUEL []Gas rqElectric []Solid SYSTEM
F1Oit FISolar
[New El,.R~lace
[]Other ~e~,~, '/rd
TYPE
glForced Air [Radiant [Steam F1AdC FIVent I~Etectric
IS CttlMNEY BEING LINED lZlNo [l~Yes - LINER SIZE.
Note: All chinmeys shall be sized per the BTU's being Tented.
[Hot Water V1Suppl. [Con. Burner
& MANUFACTURER Fie x-afl
CHIMNEY TYPE F1Chinmey A IqChimney B ~Direct Vent
HEAT LOSS []'lAs Approved [Existing ~tNot Applicable
BTU RATE r~As Per Plan [Variable [Other Vatue
DESCRIP ION OF ALL WORK BEING DONE '7~.--
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR
[3 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