HomeMy WebLinkAbout0098997-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1804 GEORGIA ST
AMERICAN HEATING & A C CO
No
98997
Gas I
[] New
Forced Air
Electric
Chimney Type ~,,~ Chimney A
Heat LoSS ~) As Approved
BTU Rate ~ As Per Plan
~ Oil
~ Radiant
b~ Hot Water
Chimney B
Owner DANIEL J/PAT CARPENTER
Category 500 - Residential-Heating & Ventilating
~ Electric
[] Replace
Steam
Suppl.
(.~ Existing
Variable
Solar
A~C I
L~ con, Burner J
Direct Vent ~ Not Applicable ]
~J Not Applicable J Value
~J Other j Value
Create Date 12/09/2002
Plan
~J Solid
[] Other
La vent j
75m
Use/Nature SFR/Replace gas furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,500.00 Plan ApproVal
$0.00 Permit Fee Paid
[] Permit Voided [
$42.50
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 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-I 130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
DEC O 9 ~0~
~:r> ~.OF
HVAC PERMITAe~EiSAT~ n~
Incomplete applications will not be processed.
OJ'HKOJ'H
ON TNI~ \~/ATI::R
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI- 54903-t 128. 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 Pertnit_fee Account System and have adequate _funds, check here
if you want this processed through your account [-~
JOB ADD.SS
CONTRACTOR_
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
[~ingle Family [3Duplex
l-lMulti-Family
I-IRental F1Commercial [3Industrial
FUEL ~Gas I-1Electric I-ISolid SYSTEM I-'lNew ~l~eplace
I-1Oil FISolar l-lOther
TYPE
[~rced Air I-1Radiant U1Steam F1A/C F-1Vent I-lElectric I llHot Water IlSuppl.ilCon. Burner
IS CHIMNEY BEING LINED F1No [~es -LINER SIZE 3 & MANUFACTURER/~
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE I-IChimney A IlChimney B ~l~Direct Vent FIOther
HEAT LOSS I-lAs Approved I-]Existing IlNot Applicable
BTU RATE l-lAs Per Plan IlVariabte ~her Value ~7-J~dc3-~
DESCmPTION OF ALL WORK BEING DONE ~/~ a,,~ .,~Z~~
VALUE (Including labor and ali materials including light fixtures) ~ .... '~-~d';~ ~
ELECTRICAL CONTRACTOR O,~ ~ctric Installation Verification form attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
3/02
off~ce
F~ 92o.23(l. so84
Electric Installation Verification
(El~x~ca Con, actor N~e) .... ' ~--
(Ad.ess) (Ci~) (Stato) (~p Code)
have been con~ted to per~b~ elec~c ins~]laion work for~~f~ ..~~/~
~e ofp~ con~cted to)
(~ddr~g whc~ work wi~ be ~fo~cd)
Thc natu:e of the Work consists of: (Check One or Describe the Nature of Work)
Reco~mection or new circuit for replacem~at Heating Plant and/or A/C Condenser.
R. ecormection or new circuit for replacement I/lectric Wa~r Heater.
Reco~.mection of the Service Entrance Cable, Meter Box, alterations to r~cep):,cles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
Cables will-require a separate permit.
Recozmection or new circuit for other permanently wired applier;des / fixtures.
O~.¢r
I hereby verii'7 this work wilt be performed by an employee o£this company and further verify the
reconnecdon / installation will b,. c~one in compliance with manufacturer and Electric code
recltti~'emerst s,
(SiL~ :.ure~of Company Officer)
(Print Name o£Oftic~r)
(Date)