HomeMy WebLinkAbout0099355-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 1256 HARNEY AVE
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner HAROLD L BIDWELL
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss IO As Approved ~ Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99355
01/08/2003
Other J
Vent J
Use/Nature SFR/Furnace replacement. *EIV form from Homeowner.
of Work
Fees: Valuation
Issued By:
$1,889.60 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$33.50
Date 01/08/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W8078 HILLCREST COURT HORTONVILLE WI 54944 -0
Telephone Number
(920) 779-8838
Omhko~h. #~ &4903. ~30' ~ 2
~ax {930) 23~-~4
· M1Y~T~ ~ F~I L¥
COMM~RCIA/,
SOLID
~ ' ~'. t, ,
~ ~ ",. - .
~. .;,..,, ~ .....
...... ~ 't
Valuation ~ , Fee~
So ~o 6z, 0oo.0o ..................................... ,~~~ ........ ~2o.o0
,i,ooo.°~ to ,~o,ooo, Si. Soo.os ~$s.5o:~Szoo.oo val~ti~ o~ p~ cher~
~lo,oo0.o~ to $25,ooo.oo ............. ~ ...... __ .................. $I5S.00 for first
Over 8~5,000. ' ..... ....
. ~ 8~00.00 ~~ o~ ~
* ~tt ~ent with applleation.~F~lu~.:g~ .~y witch 30 days will
fees bein~ ~1~ or $100.00 pl~ the n~l pe~t fee, whi~ ~r
greater. ; .~ , ,"
MAHT~AL'TURKR
I (We)
City of Oshkosh
Division of Inspection Services
215 Ch~h A~n~
~B~ IDO
~h WI ~903-1 i~0
0~ 92~&$0~0
Electric Installation Verification
the homeowner(s) of
(print homeowner(s) name)
(address where work is to be performed)
accept the responsibility for performing the electrical work as stated below for the property listed
above.
The nature of the work consists of: (Check One or Describe the NatUre of Work) [ JReconn t'
' cc ~on or new circuit for replacement~ and/or MC Condenser.
Reconnection or new circuit for replacement Electric 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.
Reconnection or new circuit for the replacement of other.permanently wired
appliances / fixtures.
__ New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi-use building would require a licensed mazter
electrician.
Other
The value of this work is $.
I hereby verify this work will be performed by me and further verify the reconnection /
installation will be done in compliance with manufacturer and Electric code requirements.
-'
Homeowner(s) Signature
(Date)
5R)2