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HomeMy WebLinkAbout0102801-HVAC (a/c)OSHKOSH ON THE WATER .lob Address 1780 CLIFFVlEW DR Contractor DRUCK'S PLBG & HTG & CLG Fuel System CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Gas J ~J Oil New J Forced Air I ~J Radiant Electric I ~J Hot Water Owner TIMOTHY J/SHELL MEYERS Category 501 - Residential-Air Conditioning L~ Electric Replace L~ Steam L~ suppl. Solar A/C Con. Burner Chimney Type I~ ChimneyA ~ Chimney B Heat Loss I~ As Approved ~ Existing BTU Rate I~ As Per Plan ~ Variable Direct Vent Not Applicable Not Applicable Other Value Value No Create Date Plan L~ Solid 102801 07/14/2003 Other J Vent J Use/Nature SFR/Replace air conditioner. *EIV form from Heritage Electric. of Work Fees: Valuation Issued By: $1,900.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $33.50 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 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0 Telephone Number (920) 426-2654 City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 RECEtVE . JUL 1 ! 2005 DEPARTMENT or O/HKO/H COMMUNITY DEVELOPMENT HVAC PERMIT APPLICATION All infomfion a~er bold categories must be provided. ~complete a~cafiom ~11 not be processed. Application(s) ~d fee(s) can be brought to CiW Hall, Room 205 or roiled m ~spechon S~ces, PO Box 1128, Os~osh ~ 54903-1128. Co~encing work ~out p~it(s) will reset in fees being doubled or $100.00 plus the noml p~it fee, which ever is ~eater. OR If you are a contractor participating in the Permit fee Account System and have adequate funds, check here if Fou want ~his processed through your account ~ DATE JOB ADDRESS OWNER CONTRACTOR CHECK [] ALL APPLICABLE USE CATEGORY ~]Single Family DDuplex FIMulti-Family [ZlRental ElCommercial D Industrial FUEL I~Gas [DElectr/c nSolid SYSTEM [~New [llReplace l~Oil U]Solar [2Other TYPE I~Forced Air ORadiant F1Steam ~A/C [~Vent r'lElectric r'lHot Wat~ F1Suppl. [~Con. Burner IS CH IMNEY BEING LINED F1No [2lYes - LINER SIZE Note: All ckinmeys shall be s~ed per the BTU's being vented. & MANUFACTURER CHIMNEY TYPE HEAT LOSS BTU RATE F1Chimney A EIAs Approved I~As Per Plan DChimney B ElExisting I~Variable [2Direct Vent I~Not Applicable F1Other Value DOther DESCRIPTION OF ALL WORK BEING DONE VALUE (Including labor and all materials including light fixtures) $ l q cO. c3o ELECTRICAL CONTRACTOR [] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be attached. If not attached or not applicable, a separate Electrical Pen~t is required. 9/02 ' ~ 0G72~/2003 09:81 920?343538 HERITAGE PAGE 82 Electric Installation Vertflcatfou (I) (we) _ ~-/~.~A~- ~ga~'~.~ c_ ('El~n.i=al Contractor Ns.ms) (altd~} (Ci~) (Sm~) (Z~ Code} have b~n ~omract~l to perform electric installation work for ~.aae-.s ,g.~.~ ..- ~¥~,. , (Acldre~ wb~s work will b~ l~a~0nn~d) Tl~e namrs of~ work ~atsisls of; {Check On~ or D~rib~ the Nn.~'~ of Work) ~'~ Rex:orm¢~lion or new circuit for replncem~nt ~ and/~ , __ R~o~o. ~ ~ ~m~t for ~ ~ W~. C~ ~[I ~uir~ a ~pMntc p~g[. ~ ~t~ ~ n~ ~rc~t for o~ ~y ~d ~1~ / ~x~_ I h~rsby Ym~i~' this work will be performc~t by ~,n ~mploye~ oflilis ~omp~r~ ang f-m'~her re'Jif'./the r~r~nne~.mon / installation will be done in compliance witll (Print N~ne of Oilier)