HomeMy WebLinkAbout0110851-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 2225 MINERVA ST
Contractor PREMIUM AIR INC
Fuel ~J Gas ~ ~J Oil
System
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner GERALD G FOLLETZ
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B O Direct Vent ~ Not Applicable I
O Existing ~ Not Applicable I Value
~ Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
110851
09/24/2004
Other
Vent J
Use/Nature SFR/Replaqce furnace
of Work
Fees: Valuation
Issued By:
$4,568.00
Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$74.00
Date 09/30/2004
Parcel Id # 1214670000
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) (Sine)
(Zip Code)
have been contracted to perform electric installation work for ~ ~c~ ~o//.'{z- ~ '
(Name ot~party contracted to)
at the follow, lng addre~: ~,~,~ /[4t~ v ~,c~ ~.
(Address where work will be performed)
The nature of the work consists of: (Ch~ck One or Describe tl'~e NaVare of Work)
Rccormection or new- cimuit for replacement I-tearing Plant and/or MC Condenser.
Reconnectlon or new circuit for replacem,nt Electric Water Heater or power vented
water heater.
Reco~m~cfion of the Service Entrance Cable, Metro- Box, alterations to mc~tacles
and lighting fixV~res due to siding/~offit i~-xallafion. Note: New Service
Entrance Cablas wilt r~/uir~ a s~parate permit.
Reconneclion or new circuit for the replaeamem of other perman~afiy wi~d
appliances / fmtures.
__ New ¢irouit for the addition of A/C xo an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
eloetrical outlets.
Other
The value of this work is $
I hereby verify this work wilt be pe~o,n'ned by an employee of this company and further vc~f~
the rec~nne~lation will b~ done in compliance with manufac:urer and Electric code
(S~nhture of Company Officer) (Print Name of Officer) (Date)