HomeMy WebLinkAbout0103319-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 1710 ARLINGTON DR
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 STEPHANIE J SCHACHERL
Category 502- Residential-Both
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 ]~ As Approved ~ Existing O Not Applicable ] Value
BTU Rate ]~ As Per Plan ~) Variable ~ Other ] Value
No
Create Date
Plan
L~ Solid
103319
08/05/2003
Other J
Vent J
Use/Nature SFR/Replace furnace and install new central air. *EIV form from Hoehne Electric.
of Work
Fees: Valuation $4,940.00 Plan Approval $0.00 Permit Fee Paid $80.00
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 O$1tkosh
Division of Impecfio~ Services
?.O, Box 1 ]30
osklcoslh WI 54903-1131)
Phone (920) 23&5050
Fax (920) 236-5084
AUG 0 4 200.] ~
,- .... ~Eg&Ii'T~IENT OF
HVAC PE~T APP~a~ .
' ~ E
Incol~lete ~plicafions ~ ~ot be proeessefl~
. A~licafion(s} and fee(s) em be brought to C~W Hal, Room 205 or m~ted m In~pecfi~ Se~ees, PO Box 1128,
Os~o~h WI 54903-I 128. C~eing w~k wiflxout pemit(~) will ~salt in fe~ berg doubled or $100.00 plm ~e
nomal pe~t fee, which ever ~s ~eater.
OR
~.~e a.eo.~.~.r~ic~a~g~ in~h~,,~Accoun~ .gvxt~ n~v* ,adeq, ua~e ~u~dg check her~
[21Multi-Family ElRentM
[3Electric Elgolid SYSTEI~'8
[3Solar
D.Cormt~cial VIInd, ustrial
~v .~eplace
2rced Air O1L~diant [3Steam [:IA/C [3Vent L-3Ele~o IZll-lot Water
Alt chit~l~eys she~ be sized per the BTU's ~e~:~g ~ entea. ·
C~iIMNEY
klEAT LOSS
BTU IRATE
[DChimney A
CIA* Approved
[3As Per Plan
12Chimt~ey B
[3Variable
ElDireet Vent CIOther
I:lNot Applicable
[3Other Value
a~
(We)
PO Box 1130
Oshkosh WI 54903-11~0
Office 920-236-5050
Fax 920-236-5084
Electric Installation VerificatiOn
(Electrical Contractor Name)
wi
(Address) (City) (State) (Zip Code)
(N of party contracted to~/
1710 '
~( moress where work will be performed)
have been contracted to perform electric installation work for
at the following address:
The nature of the work consists off (Check One or Describe the Nature of Work)
~Reconnection or new circuit forL.el~lacement Heating Plant and/or A/C Condenser.
~ Reeonnection or new circuit for replacement Electric Water Heater or power vented
water heater.
~ Reconneetion of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtur~ 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 addition of ~C to an individual dwelling unit (house or the
individual sysiems 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 r.ecormeetion / installation will be done in compliance with manufacturer and Electric code
reqmrements.
~i~iure Of Company Officer)
(Print Name of Officer)
(Date)