HomeMy WebLinkAbout0102578-HVAC (chimney)OSHKOSH
ON THE WATER
JobAddress 2214 DOTYST
Contractor
Fuel I¢'1 Gas
System [] New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
BLACK CAT CHIMNEY SERVICE & CON~
L~ Oil
L~ Radiant
[] Hot Water
[~ Forced Air
b..,I Electdc
Owner BRYAN N/KAREN L SCHULZ ETAL
Category 500- Residential-Heating & Ventilating
[] Electric ] [~ Solar
[] Replace J
No 102578
Create Date 07/02/2003
Plan
L I Solid I
[] Othe, I
L~ Steam ~J NC
[] Suppl. ~ [~ Con. Burner
Chimney Type ~ ~ Chimney A (,.) Chimney B
Heat Loss [, ~ As Approved (,2 Existing
BTU Rate ~..~ As Per Plan (, ,/ Variable
Use/Nature SFR/Tear down chimney to roof, rebuild, flash and re,ina.
of WOrk
O Direc~ Vent ~ ~ Not Applicable
O Not Applicable I Value
~ Other J Value
b~Jvent
115m btu
Fees: Valuation $970.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: ~[~lfV~ Date 07/02/2003
[] Permit Voided
In the performance of this work, I agree to perform all work pu~ rules governing the described construction.
Signature (~----~. ,.-' ~.~_~-;'~-~.._...~ ,-
Agent~Owner
Address PO BOX 1946 OSHKOSH WI 54903 - 1946 Telephone Number (920) 279-0197
Div£sion of Inspection services
2~ Church Avenue
P,O. BOX 1130
O~hkosh, WI 54903-1130
Fa~ (920) 236-5084
Phone (920) 236-5048
HVAC PERMIT APPLICATION
Ail fields/information after bold categories must be provided.
Incomplete applications will not be processed.
C~RCLE ~L APPLI~L~
USE CATE~Y~SINGLEEF~F~ILY DUPL~ M~TI-F~ILY COMMERCI~ INDUSTRI~
mL ~ oIL ELECTRIC SOm SOLID
SYST~ NEW REP~CE
~, FORCED AIR ~I~ ST~ A/C ~N~
ELECTRIC HOT WATER suppL. CON. B~R
Is CaI~ s~O ~D LINER SIZE ~"
Note: All chi~eys shall be sized per the B~'s being vented.
~I--Y ~P, CHI~EY A ~I~EY B ~~O~ER
H~T LOS, AS APPRO~D EXI STING~~~O~~
ELECTRICAL CONTRACTOR
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation Fee,~
$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;900.01 to $25,000.00 ........................................................ $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 .............................................................................. $305.00 plus $0.50
Der $100.00 valuation or Dart thereof
Submit payment with 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.