HomeMy WebLinkAbout0098998-HVACOSHKOSH
ON THE WATER
1513 CATHERINE AVE
RASMUSSEN'S HEATING & A/C INC
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
L~J Gas I L~ oil
[] New
L~J Forced Air
L~ Electric I [] Hot Water
~ Chimney A ~ Chimney B
~t As Approved ~ Existing
~ As Per Plan ~ Variable
Owner B MICHAEL SAMMONS
Category 502 - Residential-Both
[~ Electric
[] Replace
LJ steam
M suppl.
~I Direct Vent
O Not Applicable
(.~ Other
[~-olar
~c
Con. Burner
Not Applicable
Value
Value
No
Create Date
Plan
[~ Solid
[] Other
98998
07/15/2002
L_~ Vent
Use/Nature
of Work
NSFPJ
Installation of heating & cooling system.
Fees: Valuation
Issued By:
$5,460.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided ]
$87.50
Date 12/09/2002
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
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
l EC 0 929O.2
DEPARTMENT 'OF
COMMUNITY DEVELOPMENT
HYAc PERMIT APPLICATION
All illformation ~cr bold categories must bo provided.
~co~lete app~cafions ~ not be processed.
OJ'HI<O/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 vou.are a. contractor participating in the Permit fee Account System and have adequate funds, check h.ere
if you want this proc. essed through Four account ~] ....
JOB ADDRESS i513
CONTRACTOR
CR-F~CK [] ALL APPLICABLE
USE CATEGORY
I~Single Family F1Duplex
F1Multi-Family
ORental
F1Commercial
Ellndustrial
FUEL I~Gas nElectdc []Solid SYSTEM
[]Oil []Solar
F'lOther
FIReplace
TYPE
I~orced Air nRadiant []Steam ~A/C []Vent []Electric
IS CltlMNEY BEING LINED 1~o FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
F1Chimney A
s Approved
s Per Plan
OChimncy B
FtExisting
nVariable
[]Hot Water DSuppI.
& MANUFACTURER
I~irect Vent
[]Not Applicable
[3 Other Value
[]Other
[]Con. Burner
DESCRIPTION OF ALL WORK BEING DONE ../-"'~5~-I~,~r~ o~ H~-~% ~xv~ ¢~l~n5 $~,e_~
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR "
[3 For applicable projects, an Electric Installation Vehfication form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.