HomeMy WebLinkAbout0103373-HVAC (furnace; a/c)OSHKOSH
ON THE WATER
.lob Address 253 W 11TH AVE
Contractor AMERICAN HEATING & A C CO
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Owner BONNIE J CHASE
Category 502- Residential-Both
L~ Electric
No
103373
] ~] Replace ] ~ Other ]
L~ Steam
Create Date 08/07/2003
Plan
Solar ] ~ Solid
A/C ] ~ Vent
Con. Burner I
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ suppl.
Chimney Type I~] Chimney A ~] Chimney B ~ Direct Vent O 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 btu & 24m A/C
Use/Nature SFR/Replace 75m btu furnace and add 2ton 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 08/07/2003
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.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
City of Oshkosh
Division of Inspection Services
P.O. Box I 130
Oshkosh, WI 54903-1130
Phone (920) 236-$050
Fax (920) 236-5084
EECEIVED
AL], o ~ 2005
DEPARTMENT OF
nnqI,~IUNITY DEVELOPMENT
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) ~vill result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
lf ¥ou are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account
JOB ADDm SS /J.
CHECK [] ALL APPLICABLE
USE CATEGORY
~l~ingle Family CIDuplex CIMulti-Family
FIRental UICommerciat tZllndustrial
~as [3Electric mSolid SYSTEM F1New
FUEL
[3Replace
[3Oil [3Solar [3Other
TYPE
[~,_orced Air [3Radiant [3Steam ~ [3Vent [3EIectric [3Hot Water CISuppl. F1Con. Burner
IS CHIMNEY BEING LINED ZlNo [J~Zes - L1NER SIZE ,.~ e r
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CItlMNEY TYPE [3Chirrmey A nChimney B F1Direct Vent [3Other
HEAT LOSS F1As Approved ~i~xisting [3Not Applicable
BTU RATE [3As Per Plan [3Variable [~Other Value ~"~/t"~ ,~ ~d~'"0 ~/-/~-~
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ ~t/'~d~) ~
ELECTRICAL CONTRACTOR OR ~-~,lectric Installation Verification form attached(If Replacement)
E~ectrical installation of new/replacemem equipment shall be done by licensed contractors.
3/02
Electric Installation Verification
(El~tdc~ Co~tor N~)
(Addr~s) (Ci~) (S~) (~p
have been con~ted to perfb~ elec~c instal~tion work for~/~M ~/~ __,
~me ofp~ ~n~ed to)
(Ad~a whe~ wo~ ~I1 be ~fo~ed)
Thc natuce of the work consists of:
(Check One or Describe the Nature of Work)
R~o~meetion or new circuit for r~Iac~'neat Heating Plant and/or A/C Cond~ser.
R. ecormection or new circuit for r~lacem~nt Eloctri¢ Water Heater.
Recozmection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtur~ due to siding / ~offit installation. Note: New gervicz Entrance
Cables will require a separate p~iiisit.
Recoma<tion or new circuit for other perrtmnently wired appliances / fixtures,
Other
The valu~ of thi..~ work is $ ]SO.O o --.
I hereby veri f7 this worl< will I~ p~r,"ormed by an employee oft.his company and further verif~ the
r~,co .nn~c~ion / installation will b'. done in compliance with man~£acmrer and Electric code
re~u;cemems,
(Print Nam~ of Officer)