HomeMy WebLinkAbout0102816-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 734 CENTRAL ST
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner RALPH W HOEFT
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss IO As Approved ~ Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102816
07/09/2003
Other
Vent J
Use/Nature SFR/Replace furnace. * Job #1469. EIV form from Mr Teas.
of Work
Fees: Valuation
Issued By:
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$35.00
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 W8078 HILLCREST COURT HORTONVILLE WI 54944 -0
Telephone Number
(920) 779-8838
All fioldn/Lnfor~mation a~S~' bold
CIRCL~ ALL
NEW
ELE~RIC
~C
COMMBRCIAL
SOLID
I~DU~THIAL
~%NUFACTURER
DIRE~
~T
Elomtrical in. tallation o~ aew/repla~a~ ~i~:~ ~all ~ done ~ lloenme~
tout raCtOr~.
Valuatfon ~:~ Fees
e~ nnn nn a~ .... . ..... S20 O0
000.01 to 810,000,00 ................... ~ ......... =~ .............. ~20.00 for first
$10,000.00 ~1~ $I.00 ~to0.00 valuation o~ part
pe~' $100.00 val~ti~ or part thereof
~ubm/t pa~ent with app]{catfon. F~ilure.~o ~Y w/thfn 30 days will result
fees befng do.led or ~100.00 plus the n0~l permit fee, whf~ ~ver is
greater.
Electric Installation Verification
(i];Icclricai' ('ontractor Name)
(Address) (City) ~Slatc) {Zip ('ode)
have been coutracled Io perlbrm c'leclric installation work tbr
(NalllC of party contracted
(Address where work will bc perlbrmcd)
Thc nature of thc work ctmsisls of; (Chcck One or Describe thc Nature of Work)
· ~ ~c~or new (fireuit lbr rcplaccmem IlcatJx,g Plant and/or A/Ct .,,ndenser.
Recont~ection or new circuit tBr rq)laccmcnl Electric Water }lcatcr or power vellled
wfficr healer.
Reconncction of the Service Entrance Cable~ Meter Box. altcralio~s 1o receptacles
and lighting t~xlurcs duc to siding / sot]il instatlalion. Nolc: New Service
Eatmncc ('ablcs will require a separate pcmfil.
Reco~ecliou or new circuJl for thc rcplacemct:t ol'othcr pcmmncnfly wired
appliances /
New circuil Ibr thc addition of A/(' to an indivklual dwelling u~til (house or Ibc
imtividual systems m a duplex or condomi~fium I, including required se~icc
electrical outlets.
Thc value ot'this work is $
I hereby verify fl~is work will be performed by al~ employee ofttfis company ami fuflhcr verify
thc cc{ mmcctiol / installatJou ~vill be done in compliance with mamifaclm'er and Electric code
rcq uil'elIlcm ts.
( S igtmturc t~l' Ct)mp:m y (
(Date)