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HomeMy WebLinkAbout2003-HVAC (a/c)OSHKOSH ON THE WATER .lob Address 2215 WALNUT ST Contractor MARTENS HEATING & COOLING Fuel ~ Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Oil Owner ROGER R SUDA Category 501 - Residential-Air Conditioning L~ Electric No 103321 ] ~ Replace ] ~ Other ] L~ Steam Create Date 08/05/2003 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 ~] Existing O Not Applicable I Value 0 BTU Rate I~ As Per Plan ~] Variable ~ Other I Value Use/Nature SFR/linstall new central air. *EIV form from Hoehne Electric. of Work Fees: Valuation $995.00 Plan Approval $0.00 Permit Fee Paid $20.00 Issued By: Date 08/05/2003 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 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. C~ry of Oskkosh Division of In~ecfion gerv~ces P.O, Box I I30 O~hkosl~ WI 5~903d 130 Phone (920) 236-5050 Fa~ (920) 236-5084 RECEIVED AU6 0 4 2003 All info~afion after bold calegofies m~t be provi~d. hco~lete applications wiB ~t be processed. Application(s) and fee(s) can be brought to City Hall, Room 205 or roamed 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 [f~p.g_are a con_~ acte2LR-a~r,ti~.~atin~j2t. ~he Pe3L~rrtJ~fee Account_flySte,~ and have adeauat~ fu~ds,~h,eck~er~ ~Duplex ~MultgFamily glRenta,l FUEL ~Gas ~Electric Elgolid S¥STEM ~Oil IZlgol,ar El.Corm~a~rcial Fllndustrial TYPE ZlForced Air ElRadi~nt ZlSteam OMC ZlVem L'lEl~i:ric' Elttot Wafer glSuppl. CICon. Burner lIS cHrS'INEY BEING LIN]ED EINo [2lYes - LENER SLZE_ & MANUFACTURER__ Nora: All chirm~eys shall be sized per the BTU's bei:ng vented. CHIMNEY TYPE DChimney A glChim~xey B ElDirect Verst glOther tlEAT LOSS ~As Approved ElExisting ~Not Applicable BTU HATE ~As Per Plan ElVariable ElOther Value _ ELECTRICAL CONTRACTOtR Electric Installation Verification (Eleelrical Contractor Name) (Address) (City) have been contracted to perform electric installation work for (State) (Zip Code) (Name of party contracted to~/ at the following address: c~/~' ~JJ~ (Address where work will be performed) 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. Recolmection or new circuit for replacement Eleetric Water Heater or power vented water heater. Reconnection of the Service 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. Reconnecfion or new circuit for the replacement of other permanently wired ,./'/N appliances / fixtures. ew circuit for the ~d~_'fi~n Of A/C~° an individual dwelling unit (house or the individual system-t~m a dupi~x or condominium), including required service electrical outlets. Other The value of this work is $ /~, O0 · 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. (Signature of Company Officer) (Print Name of Officer) (Date)