HomeMy WebLinkAbout0102572-HVAC (boiler)OSHKOSH
ON THE WATER
Job Addrees 107 FULTON AVE
Contractor
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
MARTENS HEATING & COOLING
Owner HERRELL DEVELOPMENT LLC
Category 500 - Residential-Heating & Ventilating
Fuel I,~1 Gas I I I O, I I , I Electric
[] New I [] Rep,ece
~J Forced Air j ~ Radiant j ~J Steam
I [Electric I ~ HotWater I ~-Suppl.
[~' Solar
~J Nc
Chimney Type ~ ChimneyA O Chimney B
Heat Loss ~ ~ As Approved ( ~ Existing
BTU Rate ~ As Per Plan ~ Vadable
No 102572
O Direct Vent
Not Applicable
O Other
Create Date 07/01/2003
Plan
1 I I So,d
[] Other
j ~J Vent
[] Con, Burner
Not Applicable
I Value 0
I Value
Use/Nature ~ENTAL/Replace boiler & install chimney liner.
of Work
Fees: Valuation $2,175.00 Plan Approval $0.00 Permit Fee Paid $38.00
Issued By: "~ ~/~ Date 07/01/2003
[] Permit Voided
In the performance of ~is work, I agree to perform ail work pumuant to rules governing the described construction.
Signature
I ~.-~/ J Agent~Owner
Address P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number (920) 685-0111
City of Oshkosh
Division of Inspection Services
P.O, Box 1130
Osb. kosh, WI 549034 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PE :IT APPLICATION
All information sfter bold categories must be provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to Ciw Hall, Room 205 or marled to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I 128. Commencing w~rk without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
l~ VOU are a contraCtOr participa.tin~ in the permit fee Account System a.~.d have adeq.uate funds, .check here
i~.¥ou w_ant tM&.processed through your account ~
USE CATEGORY ~
IZlSingle Family ~Duplex IE1Multi-Family ental EICommercial Fllndustrial
FUEL fl~Gas ElElectric ElSolid SYSTEM ElNew ~eplaee
[3 Oil E1 Solar ElOther
TYPE :a~'£ DVent DEledtric/~Hot Water DSuppl. ElCon. Burner
[2Forced Air~,adiant DSteam EIA/C
IS CHiM.NEY BEING LINED ElNo,~J~,es - LINER. SIZE., & MANUFACTURER
Note: All chimneys shall be sized per the BTU s being ventea.
CHIMNEY TYPE ElChimney A [2Chimney B [2Direct Vent F1Other
HIgAT LOSS ElAs Approved FlExisting ElNot Applicable
BTU RATE [2As Per Plan ElVar/able ElOther Value
VALUE (Including l~bor a~ad all malerials inel"ding light fixtures) $ C~ / 7'5~' O0
ELECT~CAL CON~CTOR OR ~ Elee~e lns~all~i~ Verification form a~aehed(lfR~lac~t)
Electrical installation of n~lreplacement ~uipment shall be done ~ l~ansed contra~o