HomeMy WebLinkAbout0103320-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 914 E TENNESSEE AVE
Contractor MARTENS HEATING & COOLING
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 MITCH/CHRISTINA GEER
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
103320
08/05/2003
Other J
Vent J
Use/Nature SFR/Install central air. *EIV form from Hoehne Electric.
of Work
Fees: Valuation $1,095.00 Plan Approval $0.00 Permit Fee Paid $21.50
Issued By: Date 08/05/2003
Permit Voided J
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address P.O. BOX 106 WAUKAU WI 54980 - 106 Telephone Number
(920) 685-0111
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.
City of Osl~kosh
Divisio~ of h~spectio~
P.O, Box 1130
Oshkosh, Wt 549034 130
Phone (920) 236-5050
F~x (920) 236~5084
OMII4gt l.T.',; ' t..vt- NT OF '
HYAC PE IT APPLIG rfO VELoPMENT
All fzfformatian ~fter bold categories must be provided.
h~complem applications will ~aot be processed.
Application(s) m~d fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, ]PO Box 1128,
Oshkosh WI 54903 ~ 1128. Commencing work witbom permit(s) will re,ult in fees being doubled or $100.00 plus the
normal permit fee, which ever is great,r.
OR . ' · it e ccount Svste~ and ha¥~ adectuate fu~&i, check here
~ - ......actor ?)articU)at~ th~ .~d~ A ........
7-30-0 3
CIiECK 1~ ALL Aplq~ICAI~LE
cATEGORY
IJ,$ingle Family [3Duplex [3Malti-Family ~Re~tal ~Co~emial ~us~al
F~L ~(:}as ~Elee~c ~Solid SYSTEM ~4ew
~Oil ~ So~ ~Other
Eced Air ElRadieat E1Steam [3A/C ElVent EIEIe~c' DHot Water ElSappl. DCon. Burner
CHIMNEY BEING LEg'ED [3No 121Yes - LINER SIZE.__ & MANLrFAC~R
Note: All cbitrme~ sladt be smed per the BTU s ~. eg~g vetxted.
CHIMNEY TYPE ElChimney A ~Chimxey B
~AT LOSS ~As Approved ~Existing
E1Direct Vent ElOther
ElNot Applicable
BTU IRATE E1As Per Plan ElVariable ElOther Value
DESCILIPTION O1F ~L WO~E~GBO~~ ~~ ~
ELECT~CAL CO~CTO Electrical i~all~ion of n~lr~p~m~ equCmet~t ,,hall be done ~ h~e~ contrae
a~
Electric Installation Verification
(we)
(Electrical Contractor Name)
(Ad.ess) (Ci~) (S~te) (Zip Code)
have been contracted to perform electric installation work for
(Name of party contracted to)
at the following address:
(Address where work will be performed)
The nature of the work consists off (Check One or Describc the Nature of Work)
__ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
__ Reconnection or new circuit for replacement Electa'ic Water Heater or power vented
water heater.
__ Reconnection of the Sendce Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures. ~
__~' New circuit for the additiqfi~of~C~an individual dwelling unit (house or the
individual systems in a clUb-ex or condominium), including required service
electrical outlets.
Other
The value offs work is $ /bS, a9
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
(Date)