HomeMy WebLinkAbout2002-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address 1075 MARICOPA DR
Contractor E C MERRILL INC
Fuel [~s ]
System [] New
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner PATRICKJMARY B CONNORS
Category
U Oil I ~J Electric
I [] Replace
~_J Radiant J LJ Steam
I I Hot Water t L~ suppl.
Chimney Type ~ ChimneyA ~.~ Chimney B
Heat LoSs ~.~ As Approved ~ Existing
BTU Rate ~ As Per Plan ~.~) Variable
Direct Vent
500 - Residential-Heating & Ventilating
[] Solar
J ~1 Nc I
I ~-Con. Burner
O Not Applicable
~1~ Not Applicable I Value
~1~ Other I Value
No 98976
Create Date 12/06/2002
Plan
I I Solid
[] Other
Vent
Use/Nature SFPJ Replace furnace. *EIV form from Witzke Electric,
of Work
Fees: Valuation
Issued By:
$3,600.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided I
$59.00
Date 12/06/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 804 WITZEL AVE OSHKOSH WI 54902 - 5710 Telephone Number
(920) 235-3600
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
DEC 0 6
All ~o~~}'~[d ~t~nes must be prowded.
Inco~lete applicafiom M~ not be Processe&
O/kKO/H
ON, THE WATER
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Service.% ~PO Box t 12g"
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doublecolor $I00.00 plus the'
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate ]funds, check here
if you want this processed through Four account
JOB DDP SS IO"/5' AA
CONTRACTOR _?=..~---. ~ ~_..~--l~..t ~
cIq'ECK [] ALL APPLICABLE
USE CATEGORY
[5~85ngle Family [2Duplex
E]Multi-Family
ElRental V1Commercial Fllndustrial
FUEL .l~Gas I-IElectric nSolid SYSTEM F1N.ew .4~Replace
E1Oil VISolar FlOther
TYPE
[~l~orced Air nRadiant V1Steam F1A/C F1Vent fi]Electric rlHot Water V1Suppl. F1Con. Burner
IS CHIMNEY BEING LINED [~t'No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFAC~R
CHIMNEY TYPE V1Chimney A [:]Chimney B ~irect Vent UtOther
FtEAT LOSS fi]As Approved VIExisting F1Not Applicable
BTU RATE fi]As Per Plan V1Variable F1Other Value
DESCRIPTION OF ALL WORK BEING DONE T~-,~~ ~:2oix,~
VALUE (Including labor and all materials including light fixtures) $ ~' ~:v~}
ELECTRICAL CONTRACTOR OR [] Electric Installation Verification form attached(If Replacement)
Electrical installcaion of new/replacement equipment shall be da~e by licensed contractors.
3/02
DEC. 4. 700F. F ,' 05PH ~IITZKE ELECTRIC: . MC,, 976 P. ~ '~
(Elec~c~ Con~ctor Nmos) --
(Ad~) (City) (S~ato) (Zip Code)
contacted to peffozm et¢c~c ~stallation work for ~1 ~
~me ofp~y comracted
~Ad&e~s ','~r~ work will be p~fc~ed)
efta work co~i~ts of: (Check On~ or Desc~be ~e Na:me of Work)
R¢co~ec~on or n~' circ~t for r~Iaoement Heating Pi~t ~or ~C Condenser.
r~cormecfion or new okcuit for replaeemen~ Blec~.c Water H~atcr or power
w~ter heater.
Reco~!ec~[o~ of ~c $~.~ice Entrauce Cable, Me,er Box, alt~ations to receptacles
mud !i~mg fix~are~ duc to ~iding / soffit installation. Nero: New Ser¢ice
En~ce Cable~ will recite a s~at~ pemit.
R.eeo~ectXmx or n~w circui~ for the replacemeat of other p~entiy wired
appHmces / fixture~.
Now ckcuit'for ~e addition cftC to ~ z~divlduaZ d'~sii'f,g unit (house or the
~di,~du~ sy~tem~ in a duplex or condo~), ~ciuding required
electrical
The vMue of ~is wo~ i.~ $.~.~~.
I hereby verify ¢j$ work will be performed by at employee ofthi~ company ~d fuxher verify
the r~cormeerion / in~t~!lation will be done in compli~ce with manufacturer and Eiec~c ~od¢
rcquiremeats.
(Signature of Compa~.y
(Print N~m~ of Ofdcer)