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HomeMy WebLinkAbout0102570-HVAC (furnace & a/c)OSHKOSH ON THE WATER Job Address Contractor CITY OF OSHKOSH HVAC PERMIT -APPLICATION AND RECORD 659 EVANS ST MARTENS HEATING & COOLING System [~.New No 102570 Fuel I IGas I I IOil ~ Forced Air ~ ~j Radiant I I Elec'[ric I I I Hot Water ~,~ Chimney B Owner KEITH RJMICHELL WOLFE Category 502 - Residential-Both I I Electric [~_ Replace ~ I LI Steam Create Date 07/01/2003 Plan I I solar I [~ Solid J~_ Other L~J NC J L~ vent I ,I Suppl. ChimneyType L) ChimneyA Heat Loss (..) As Approved { ~ Existing BTU Rate ~ ~ As Per Plan OVadable Direct Vent k,,.,J Con. Burner I ~ Not Applicable J ~J~ Not Applicable J Value ~ Other I Value Use/Nature [SFR/Replace furnace & add central air. of Work Fees: Valuation Issued By: k ~ $5,900.00 Plan Approval $0.00 Permit Fee Paid [] PermitVoided [ $93.50 Date 07/01/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature ~,/~..-,,~/~z"2'~ '/~/~Agent/Owner Date Address P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number 7-/- (920) 685-0111 City of Oshkosh Division of Inspection Services P~O, Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 HVAC PERth&iT APPLICATION Ail fnfornmtion after bold categories must be provided. Incomplete applications will not be processed. OZHKO/H Application(s) and fee(s) can be brought to City Hall, Room 205 or ma/ted to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work'adthout permit(s) will msutt in fees being doubled or $100.00 plus the normal permit fee, which ever is greater. OR ~O_U are_~a coBt~_r.~actor partic~.p-atin~:jn the permit fee Account System and have adeq.uate fun. ds, check here ~ou ~ant this processed through. ¢our account..[[] ow R Iff inch ce- CI-IECK I~ ALL AI?lffLICAlttLE CATEGOP~Y ngle Family I21Duplex fflMnlti-Family FIRental [3Commercial FUEL I21Gas I-lElectric ElSolid SYSTEM ~OO~Ver~ [.]Oil ~Sotar IDlndustrial T E ~oo~ced Air ~Radia~t ~Steam ~(¢~/C ~Vent ~Ele~tric ~Hot Water ElSuppt.[21Con. Burner Note: AH ehfimeys sh~l be sized per ~e B~'s being vented. · Cffi~qEY ~E ~Chi~y A ~Chimey B ~Direct Vent ~Other ~AT LOSS ~As Approved ~Existing ~Not Applicable BTU RATE ~As Per PI~ ~Variable ~Oth~ Value DESQmPTION OF ~L WO~ BErG DO~~~~ t ELECTIIICAL CONTRACTOR ~ ]~ t/P~' O]~ ~ Electric lnstallatioa Verification form at~ached(If Replacement) ~-- EJ~trictll#lstaEationofnew/replacementequipmentshallbedonebylicensedc°ntract°