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HomeMy WebLinkAbout0102805-HVAC(~ CITY OF OSHKOSH OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 650 GROVE ST Owner DEWEY HOMES INC Contractor AMERICAN HEATING & A C CO Category 500 - Residential-Heating & Ventilating Fuel ~J Gas J ~J Oil b~ Electric ~J Solar System ~J New ~ ~J Replace ~ ~J Other ~J Forced Air I ~J Radiant L~ Steam ~J A/C ~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner Chimney Type I~ Chimney A O Chimney B ~ 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 75m btu No Create Date Plan ~J Solid Vent 102805 04/09/2003 Use/Nature NSFR/ Install 75m btu furnace and air exchanger. of Work Fees: Valuation Issued By: $4,600.00 Plan Approval $0.00 Permit Fee Paid Permit Voided $74.00 Date 07/14/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number (920) 235-8090 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 APPLICATIO AIl informatio~ after bold categories must be provided. Incomplete appiicatiogs will not b¢ processed. O/HKOSH 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 ever is greater. OR l£vou are a contractor participating in the Permit fee Account System and have adequate funds, check here if you want this processed throuf~h ¥onr account [~ JOB ADD. SS CHECK [] ALL APPLICABLE USE CATEGORY ~(Single Family V1Duplex I-lMulti-Family EIRental UlCommercial Fllndustfial FUEL J~as F1Electric EISolid SYSTEM ~g~ew FIReplace FIOil [2]Solar F1Other _oPE rced Air E]Radiant r-lSteam VIA/C j~ent []Electhc F1Hot Water F1Suppl. V1Con. Burner IS CHIMNEY BEING LINED ~g/~o F1Yes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE FIChimney A ~2himney B D~irect Vent F1Other HEAT LOSS FIAs Approved 12]Existing jONot Applicable BTU RATE F1As Per Plan F1Variable ~ther Value DESCRIPTION OF ALL WORK BEING DONE ~-/O..q/~// ~CO/)d) . .,vg .,'.-1(,¢.,,.. Co.o. I5 - VALUE (Including labOr and all materials including light fixtnres) $ ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(If Replacement) Electrical installation of new/replacement equipment shall be done by h'censed contractors.