HomeMy WebLinkAbout0099472 HOSHKOSH
ON THE WATER
247 W SOUTH PARKAVE
RASMUSSEN'S HEATING & A/C INC
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner HAROLD/YVONNE H KRIZ
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99472
01/16/2003
Other J
Vent J
120m btu
Use/Nature RENTAL/Replace furnace. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$3,700.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$60.50
Date 01/16/2003
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
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (~20)
HVAC PERMIT APPLICATION
All information af~ bold categories must bo provided.
ON THE WATER
· Application(s) and fee(s) can be brought to City HaH, Room 205 or mailed to Inspection Se~ices, PO Box 1128,
Oshkosh WI 54903-I 128. Commencing work without permit(s) will result in fees being doubled or $I00.00 plus the
normal permit fee. which ever is greater.
OR
If you are a contractor oarticit~attne in the Pg,rtnit, fee ,Account $¥s,tem, and &ave adeouate, funds, check here
ff -vou want this _~roces~ed tttr~ugh _~our accoUnt i iN .... -... -
C[~.CK [] ALL APPLICAB!JE
U~ CAT~GORY
ElSin~le Family EIDuplex
IZIMulti-Family
fflCommercial
ElIndustrial
FUEL ~g[Gas OBlcctfic El~olid SYSTI~I
EIOil ElSolar
fflNew ~R~Iace
[3Other
TYPE
~ForcedAir EIRadisnt EIS~__m_ EIA/C E]Vcnt EIElectric
IS ~Y B __~!NG~ EINo ~es - LINER SIZE
Note: All chinmeys shall be sized per the BTU's being ven~d.
CHIMtgE¥ TYPE EICbinmey A ~ICMnmey B
BTU RATE EIAs Per Plan []Variable
13Hot Waist EISuppl. EiCon. Burner
& ~A~R F/e,,..
EIDireot Vent ~OthCr
EINot Appli~ble
~[Othcr Value /o~0, ~0~
~?-U
VALU~ (Including Inbor and all mnterinls ineludtng light fixtures)
attached. If not at.bcd cf not applicable, a Selmrate Blectri~ Pem~t is
Electric Installation Verification
I (W~,) , , ,
(,~) " (cit~)
(Nam, ofl~ oontmoted