HomeMy WebLinkAbout2003-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 714 POWERS ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
RASMUSSEN'S HEATING & A/C INC
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MICHAEL J DOUGLAS
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102762
07/11/2003
Other
Vent J
80m
Use/Nature SFR/Replace furnace and add A/C. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$4,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$78.50
Date 07/11/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number
920-235-6569
P.O. Box 11~0
Oq~M~ll30
Pllonc (~20) 23~.'m50
HVAC PERMIT APPLICATION
~M1 infommtion after bold categories must be provided.
Incomple/e applicati~ms will not be processed.
· Applicator(s) and f~(s) can bo lmmght to C~y Hall, Room 205 or mailed to hspecfi~m Se~vi~ PO B~ 1128,
Oshkosh WI $490~-1128. Comment/rig work w/thout p~it(s) will result in fees be/rig doubled or $100.00 plus the
normal permit fee, which ever is ~reater.
OR
ff you are a contrdetor nartici~atin~ in the Permit fee ~lccount System and have adeauate funds, cheek here
ff YoU want this processed through your account .["'] -. ·
CON'ri~ACTOR ~o,~o~o ~.~,'~ t4 VA c,
DATE 7-/o-a 3
cm~CK [] ALL AI~PLICABL~
USE CATEGORY
[/~/nglo Fsm/ly [2Duplex
[2Industrial
FUEL IN~as ~Elec~ric ~Solid SYSTEM ONew
C]Oil ClSolar I2Other
I~Replace
EIHot Water ClguppL
& MANU~A~
B [2Direct Vcnt ElOthcr
f~'qot Applicable
ElVmlablc [~)therValuo 00,0oo
ClCon. Burner
Electric Tnstallation Verification
I(Wo)
('Electrical Contraotor Name)
(City)
have b~n contmoted to perform el~hio installation work for
at the following address:
(State) (Zip Code)
elaine of party contracted to)
(Ad~ wh~ work will be p~rformed)
Th~ nature of the work ~onsiats of ( .Ch~k One or D~a~n'bc the Nature of Work)
The .value oft~l~ work is $ ¥CD.°°
I h,m~bX ve,~-y ~, work will bc !~ by an ~ o£mis co,,?an~ :~,,fl fi, rthc~ ~
the ~eclion / iaslallafion will be dmae in compliance wlih manufacttuot and t!ka~hlc code
7-/o -o 3