HomeMy WebLinkAbout0110750-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 1136 BUCHANAN AVE
Contractor PREMIUM AIR INC
Fuel [~J Gas ~
System ~ New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner KEITH W WOLFF
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type le Chimney A ~ Chimney B ~ Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved e Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
110750
09/24/2004
Other
Vent J
Use/Nature SFR/Replace furnace and A/C, and install chimney liner - EIV provided by Premium Air
of Work
Fees: Valuation
Issued By:
$5,008.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$81.50
Date 09/24/2004
Parcel Id # 1604760100
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
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.
Signature Date
Agent/Owner
Address N3225 HWY 15 HORTONVILLE WI 54944 -0 Telephone Number
920-982-3323
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.
Electric Installation Verification
(We)
(Electrical Contractor Name)
(Address) (City) (State)
(Zip Code)
have been contracted to perform electric installation work fer
(Name of party contracted to)
at the following address: II ~? ~ ,~/3,~,,~,~ ~ ~.~
(Address where work will be performed)
The nature o£ the work consisls o f: (Check One or Describe the Nature of Work)
Recennection or new circuit for replacement Hea~ing Plant and/or A/C Condenser.
.. Reconnection 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 fixtures due to siding / soffit installation. Note: New Sen, ice
Entrance Cables will require a separate permit.
. Reconnecl~on or new ctremt for the replacement of other perm~,antlyw/red
appliances ! fixtures.
-- New circuit for the addition of A/C :o an individual dwelling unit (house or the
individua! systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ ....O~().O ~
I hereby redly m;~,,,~ ,- -,, -
. . w,o ,~,r~c wm oe perfmmed by an en~ployee of this company and furl.her vc~fy
the reconnection / installation will be done in compliance with manufac:urer and Electric code
requirements.
2 ( gnature of Company Officer) ~- r(/.-~)q
(Date)
(Priht Name of Officer)