HomeMy WebLinkAbout0098996-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1941 BEECH ST
AMERICAN HEATING & A C CO
l~1 Gas I II Oil I
[] New I
Forced Air I L-~ Radiant
Electric I L~ Hot Water
[]) Chimney A
~ As Approved
~..~ As Per Plan
Chimney B
(...~ Existing
~ Variable
Owner JEFFREY J JACOBSON
No 98996
Create Date 10/30/2002
Category 502 - Residential-Both Plan
U Electric I bJ Solar I LJ Solid I
[] Replace I [] Other
LJ Steam I ~ Nc I ~_~ Vent
L J suppl. I ~ Con. Burner I
O Direct Vent [.] Not Applicable
~1~ Not Applicable I Value 0
~ Other I Value 100m btu & 42 m btu
Use/Nature
of Work
INSFPJ Install furnace, central NC and air exchange system.
Fees: Valuation
Issued By:
$8,000.00 Plan Approval
$0.00 Permit Fee Paid
$125.00
Date 12/09/2002
[] Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 - 6437 Telephone Number
(920) 235-8090
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
BEC 0 9
HVAC P E ENT
All info~ation after bold categories must bc provided.
Incomplete applications will not bc processed.
OJ"HKOJ"H
ON T~qF WATER
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI. 54903-112 8. 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 partic~pqting in the Permit fee Account System and have adequate funds, check here
if Vou want this processed thrott~h your account ~']
OWNER
CONTRACTOR
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
]~¢ingle Family U1Duplex
UIMulti-Family
U1Rental F'lCommercial Fllndustrial
FUEL ~i~Gas UlElectric ~Solid SYSTEM l~ew FIReplace
U1Oil [] Solar FIOther
TYPE
[~rced Air []Radiant F1Steam ~/C [~St~nt []Electric []Hot Water l-lSuppl. F1Con. Burner
IS CHIMNEY BEING LINED ~o []Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE fi]Chimney A UIChimney B lii]:Direct Vent fi]Other
HEAT LOSS F1As Approved UIExisting ~ot Applicable
BTU RATE fi]As Per Plan [1Variable ~,J~l.Other Value
DESCRIPTION OF ALL WORK BEING DONE -~/~r5 //?- //
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
OR [] Electric Installation Verification form attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
3/02