HomeMy WebLinkAbout0099356-HVAC (furnace)OSHKOSH
ON THE WATER
JobAddres$ 1311 GRAND ST
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 GEORGE MEISEL ETAL
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
99356
01/08/2003
Other J
Vent J
Use/Nature SFR/Replacement of furnace. *EIV form from Homeowner.
of Work
Fees: Valuation
Issued By:
$2,111.25 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$38.00
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
Ail ~_ields/information attez< bol'd Incomplete appli~ations
~o~0~
CIRCLS ALL APP~Z~
USE ~ DU~X .
gYST~ N~
.:
No~e~ All chi~eye shall be ~tzed pe~. ~:' . '~ ,4~ .
must be provided.
A/C
COMMERCIAL
SOLID
INDUSTRIAL
CON. BURRRR
M~NUFACTURER
HIIAT LO88 ':EXISTI.N~:i NOT APPLICABLE
Electrical installa=ion of new/replace~a~ e~i~ ~all ~ done by ltcens~
Valuation
$0 to $1,000
$1,000.00 p~S; ::$1.50 :~$ 8100.00 valuation or part thereof
010,0o0.01 to ~25,oo0 lUb :$L.00 '~i~$'i0o.00 valuation or part thereof
. oo
$~o,ooo.oo
~ $I00.00 valuation or part ther~
· ~bmit pa~ent with application. ~. F~i!ur~;,gO ~ay within 30 days will result in
fees bein~ do. led o~ $100.00 pl~8
greater.
Electric Installation Verification
1 (We)
(Electrical Contractor Name)
k/1 s' / Y ?
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for //-.I ',8rso%,;~ ?' :,q'/(_ .,
(Name ot p~rty contracted to)
(Address where work will be performed) /k4vv,.~/~ '
The nature of thc work consists of: (Check On, or Describe the Nature of Work)
/ Reconn~:tion or new circuit lbr replacement Heating Plant and/or A/C Condenser.
Re¢onnection or new circuit lbr replacement Electric Water Heater or pow~ vented
water heater.
Reconncetion of the Service Entrance Cable, Meter Box, alteration, to receptacles
and lighting fixtures duc to siding ! ~offit installation. Note: New Service
Entrance Cables will require a ~parat¢ permit.
Rcconnection or new circuit for the replacement of other pem~anently wired
appliances / fixtures.
New cimuit ~r the addition of ~C m an red, vidal dwelfing unit (house m'
individual s~tems in a duplex or condominium), including ~eq~fired
electrical outlets.
Other
'rhe value of this work is $
I hereby verify this work will be pe,'fom~ed by an employee of this company and further verify
thc rcctmneclion / installation will be done in compliance with manufacturer and Electric code
requirements
( Si).,,'Jlai ta'c t) f Compat~y Officer)
(Print Name of Officer)
(Date)
5102