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HomeMy WebLinkAbout0102947-HVAC (furnace & a/c) SHKOSH ON THE WATER .lob Address 424 ANNEX AVE Contractor AMERICAN HEATING & A C CO Fuel ~J Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Oil Owner EDWARD B CLEMENTS Category 502- Residential-Both L~ Electric No 102947 ] ~] Replace ] ~ Other ] L~ Steam Create Date 07/21/2003 Plan Solar ] ~ Solid A/C ] ~ Vent Con. Burner I Forced Air ] ~ Radiant Electric I ~J Hot Water L~ suppl. Chimney Type I~] Chimney A O Chimney B ~] Direct Vent ~ Not Applicable I Heat Loss I~] As Approved O Existing ~] Not Applicable I Value 0 BTU Rate I~ As Per Plan ~] Variable ~ Other I Value 75m-24m A/C Use/Nature SFR/Replace furnace and add 2-ton central A/C. *EIV form from Seckar Electric. of Work Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $65.00 Issued By: Date 07/21/2003 Permit Voided 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 To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. ity of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 R ( ED HVAC PERMIT APPLICATION DEPARTMENT OF inror~tion aaer bold categories mnst be provided, ,"~©[¢~dUNiTY DEVELOPMENT Incomplete applications will not be processed. · Application(s) and fee(s) can be brought to City ltall, 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 If vou are a contractor participatin~ in the Permit fee Account System and have adequat'e funds, check here if you want this processed through your account CHECK [] ALL APPLICABLE E CATEGORY ingle Family ElDuplex [3Multi-Family E3Rental FICommercial Dlndustrial FUEL ,,J~as [3Electric FlSolid SYSTEM FINew ~eplace il FtSolar FIOther rced Air IDRadiant F1Steam ~/C [3Vent I-tElectric [3Hot Water F1Suppl. V1Con. Burner IS CHIMNEY BEING LINED ~l~o [3Yes - LINER SIZE & MANUFACTURER Note: All chimneys shall be sized pdr the BTU's being vented CHIMNEY TYPE HEAT LOSS BTU RATE [3Chimney A [2lAs Approved [3As Per Plan DESCRIPTION OF ALL WORK BEING DONE 2.- /_. ~2'~imney B r-lDirect Vent FIOther ~'-xisting FINot Applicable VALUE (Including labor and all materials including light fixtures) $ ELECTRICAL CONTRACTOR O.__~g ~lectric Installation Verification form attached(If Replacement) Electrical installation of newh'eplacernent equipraent shall be done by licensed contractors. Electric Installation Verification (El~cal Con~tor N~e) (Address) (City) (State) (Zip Code) have been centered to peseta elecmc installation work for ~e ofp~y ~n~ct~ to) at the following ~ss: ~2¢ (A~ess where work ~11 be The nature of the work consists of: (Check One or Describe the Nature of Work) ... ~>~ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser. ~ Reconnection or new circuit for replacement Electric Water Heater or power wntcd water heater. ~ Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to s/ding / ~offit installation. Note: New Service Entrance Cables will require a separate permit. __ Reconnecfion or new circuit for the replacement of other permanently wired appliances / fixtures. __ New circuit for the addition of A/C to an individual dwelling unit (house or the individual systems in a duplex or condominium), including required service electrical outlets. Other The value of this work is $ I hereby verify this work will be performed by an employee of this company and further verify the reconnection / installation will e done in comphance w~th manufacturer and Electric code requirements. (Signature of Company Officer) (Print Name of Officer) (Date) 5/02