HomeMy WebLinkAbout2003-HVAC (central a/c)OSHKOSH
ON THE WATER
Job Address 917 SCHOOL AVE
Ceetracter MARTENS HEATING & COOLING
Fuel I J Gas I [] Oil
System [] New ~
~J Radiant
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
ChimneyType K~ ChimneyA
Dot Water
Owner SUSAN I LAIN
Category 501 - Residential-Air Conditioning
b..I Electric I L~T Solar
[] Replace I
~ Steam j ~J NC
~ Suppl. ] ~' Con. Burner
~,.~ ChimneyB {~ DirectVent O NotAp¢icable I
Heat Loss ~ ~ As Approved
BTU Rate [, ~ As Per Plan
USeo/fN~oUrr~ IFPJ Install 1.5 ton central air.
Existing O Not Appliceble [ Value
Vadable ~ Other I Value
No 102571
Create Date 07/01/2003
Plan
I ~ Solid
[] Other
~] Vent
Fees: Valuation $1,375.00 Plan Approval $0.00 Permit Fee Paid $26.00
-~z/~,'~ Date 07/01/2003
Issued By:
[] Permit Voided J
In the performance o~th~ work, I agree to perform all work pursuant to rules governing the described construction.
Signature
! '- L/' ,} Agent/Owner
Address P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number (920) 685-0111
City of oskkosh
Dfvision of Inspection Services
P.O. Box 1130
Oskkosh, WI[ 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City Hail, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 549034 128. Commencing work without permit(s) will result in fees being doubled or $t00.00 plus the
normal permit fee, which ever is greater.
OR
If you are a co~tractor partici.r)ati~t~ in the permit fee Account SVstem a~d have adequate funds, check here
~'f yeu want this processed through ~our account
COSmCTO iq a r?e 5
CHECK I~ ALL APPLICABLE
~T~E CATEGOI~Y
~[~)ngle Family ~Duple×
E1Multi-Family ~Rental
ElComm~rcial
Fllndustrial
FUEL ~Gas ~Electric FISolid SYSTEM F1New UlReplaee
121Oil DSolar ~Other
~Forced Air ~Radiant EIStea C [ZIVent F1Eledtr/c F1Hot Water ClSuppl. ElCon. Burner
IS CH1TvlNEY BEING LINED,~No Cl.Y,,es - LINER SIZE. & MANUFACTURER
Note: All chimneys shall be sized 15er ~e BTU s being vented.
cHIMNEY TYPE ~Chimney A ~Chimney B nDirect Vent F1Other
BLEAT LOSS ~As Approved fflExisting nNot Applicable
BTU RATE EIAs Per Plan ~Variable F1Other Value
DESCmrTm WOaXBEING.p'O _Z /, 5
ELECTRICAL CONTRACTOR ,;'L'/O Q.~ D ~'*--' O] [] Electric Installation Verification form at,ached(If Replacement)
.... El~trical in*iallatfon of newNeplaaement equipment shall be done by licensed contracto