HomeMy WebLinkAbout2006-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 805 RANDALL PL
Contractor DRUCK'S PLBG & HTG & CLG
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CYNTHIA L BOUSHELE
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO ChimneyA ~ Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan O Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99720
02/06/2003
Other J
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Heritage Electric.
of Work
Fees: Valuation
Issued By:
$3,194.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$53.00
Date 02/06/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0
Telephone Number
(920) 426-2654
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECE[VEI
FEB 0 5 2.003 O/HKO/H
ON THE WATER
I PP'M ,C.~I~ r UENT OF
HVAC PERM T A
Incomplete applications will not be processed.
· 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 you are a contractor participating in the Permit fee Account System and have hdequate funds, check here
if you want this processed through your account [-]
CHECK [] ALL APPLICABLE
USE CATEGORY
[~[Single Family F'IDuplex
V1Multi-Family
VIRental VI Commercial Vllndustrial
FUEL I~Gas FIElectric []Solid SYSTEM []New 12RReplace
[]Oil []Solar []Other
TYPE
[3'Forced Air []Radiant []Steam []A/C []Vent []Electric []Hot Water FISuppl. []Con. Burner
IS CHIMNEY BEING LINED l~No [3Yes - LINER SIZE
Note: All chiraneys shall be sized per the BTU's being vented.
CIIIMNEY TY~E ~[Chimney A []Chimney g
HEAT LOSS []As Approved [~Existing
BTU RATE []As Per Plan ~ariable
& MANUFACTURER
[3Direct Vent []Other
[3Not Applicable
[3Other Value ~/~ ~
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
ELECTmCaJ_., CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
01/0~/2003 87:18 9287343838 HERITAGE PAGE
~ ~[/0~/0~ 11:19 FAX ?Z~O~i
Electric Installatiou Verification
(AddFc~ where work wi{] lmm pe~ommed)
Thc ueture of ~¢ work ~nsim of: (C~e~ One or Describ~ ~ Narm~ of WorlO
Recoun~ ~t new cimu}t for rcpla~mucnt~°r AYC Condenser.
R~o~e~ou or n~ ci~uit for ~hc~z E{~c Wa~ Heatmr,
{i~ug 5x~s due ~
R~~on ~ n~ ~uit for o~ p~fly ~ ~li~o~ / fix~,
0~
($i~re of Company
Name