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Home My WebLink About2002-HVAC (boiler) CITY OF OSHKOSH OSHKOSH HVAC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 716 VIOLA AVE Owner LARRY J CLARK/MARSHA K ANICK Contractor RASMUSSEN'S HEATING & NC INC Category 500 - Residential-Heating & Ventilating Fuel ~J Gas U Oil I ~ Electric I [~ Solar System [] New I [] Replace ~J Forced Air [_j Radiant J [__J Steam I ~_J A/C M Electric ~J Hot Water I U Suppl. I [] Con. Burner Chimney Type ~ Chimney A O Chimney B ~ Direct Vent ~.~ Not Applicable Heat Loss ~.~ As Approved ~t Existing ~ Not Applicable I Value BTU Rate ~ As Per Plan ~ Variable ~ Other I Value 75m btu No Create Date Plan ~J Solid [] Other Vent 98648 11/14/2002 Use/Nature SFR/Replace boiler. *EIV form from Slim's Electric, of Work Fees: Valuation $3,742.00 Plan Approval $0.00 Permit Fee Paid Issued By: [] Permit Voided/ $62.00 Date 11/14/2002 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number 920-235-6569 City of Oshkosh DMsion of I~v~tbn Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. OA---tKO/H ON THE WATER Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed 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 If YOU are a contractor.participating.in the Perrnit fee ~Iccount System and have.adequate.funds, check here if you want this process.ed through .your. account ['~ DATE 7i6 V% JOB ADDRESS OWl~R /- ~r-/ CONTRACTOR CH1ECK [] ALL APPLICABLE USE CATEGORY mingle Family [3Duplex [3Multi-Family F1Rontal [3Commercial FIIndustrial FUEL il!ilGas ElElectric ElSolid SYSTEM F1New F1Oil ElSolar FlOther iii[Replace TYPE FIForeed Air E1Radiant F1Steam EIA/C EVent F1Electric j!llHot Water F1Suppl. IS CHIMNEY BEING LINED I~INo OYes - LINER SIZE Note: All chimneys shall be sized per the BTU's being vented. & MANI3FAC~R CHIMNEY TYPE HEAT LOSS BTU RATE ElChimney A nAs Approved FIAs Per Plan ~[~[ExiChimney B sting rlVariable I-IDirect Vent FlOther F1Not Applicable ElOtherValue 7.%OOO ECon. Burner DESCRIPTION OF ALL WORK BEING DONE Replace. VALUE (Including labor and ali materials including light fixtures) $ 3 ~] ~ ~2 Er~ermcAc coNx~croa ~ [ ~ ~'o Et~t. ~-~ , l~For applicable projects, an Electric Installation Verification form, signed by?the Electrical Contractor, must be attached. If not attached or not applicable, a separate Electrical Permit is requited. Electric Installation Verification O~leotr/,al Contra~r Niinle) l~ve Mn conlracl, d ~o perform electric ~on work for ,mt ,, (State) (zip Code) · (lqa~ae of party oontra~.d to) at the :lbHowing address: (Addr~ w~'wo~ v~/be p~formed) The nature of the work consists of: (.Ch~ One or Deson'be the Nature of Work) Receanecg~n or ae~ cirouit tbr replacement Heating Plant and/or A/C Condenser. Reconuecli~n or new circuit for replacemellt Illectdc Water Heater or power vented Reconnecfion of the Servi.ce F, ntmnce Cable, Meter Box, alterations to receptacles. and lilgehtg ffnmees due to sidi~ / soffit inslallagom Note: New Service F. utmnoe Cables will require a sepmate permi~ Recmmeciion or new circ~ for the replaoement of 01her permanently wired applhalces / fnCmres. New oirouit for the addition of A]C to ~m ~un/dwelling nm't Omu~ or the The value of this work is $ 1~ ©. ,c~ .