HomeMy WebLinkAbout0117709-HVAC (furnace; a/c)
~
OSHKOSH
ON THE WATER
Job Address 648 JEFFERSON ST
CITY OF OSHKOSH
No
117709
HVAC PERMIT - APPLICATION AND RECORD
Owner
YVONNE M ATTOE
Create Date 12/29/2005
Plan
Contractor PREMIUM AIR INC
Iv'1 Gas I 1 Oil
Fuel
System n New I
~ Forced Air U Radiant
1 I Electric 1 I Hot Water
Chimney Type r) Chimney A ( ) Chimney B
Heat Loss r ) As Approved ( ) Existing
BTU Rate r ) As Per Plan ( ) Variable
Category 502 - Residential-Both
1"'1 Electric
I I Solar
I 1 Solid
PI Replace
U Steam
I I Suppl.
( ) Direct Vent
0 Other
~ AlC I U Vent
I I Con. Burner 1
. Not Applicable
. Not Applicable
. Other
Value
Value
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of Work
Fees: Valuatio
$5,933.00
Plan Approval
$0.00
Permit Fee Paid
$95.00
Issued By:
Date 12/29/2005
0 Permit Voided I
Parcelld # 0402570000
In the performance of this work, I agree to perform all work pursuant to rules govemlng the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which It is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address
N3225 HWY 15
HORTONVILLE
WI 54944-0
Telephone Number
920-982-3323
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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C;tyofOshkosh
D;,;s;oo ofl",p"';oo S",,;m
2J5 Chu"h A"ou'
PO Bo' 1130
Oshkosh WI 54903-II30
om" 920-236-5050
Fox 920-236-5084
Electric Installation Verification
:P""ofYIl,Uh ~. )nc. - On-e... ~;J
. / (Electrical Contractor Name)
>SId:> ß,r...e.l." VIL-iLe.'--{ R..JJ
(Address)
b¡¡l,,~,
(City)
:5<.{qot{.-
(Zip Code)
cDI
(State)
have been contracted to perfonn electric installation work for 'II} ()..-,rv 4t+o~ >
(Name of party contracted to)
at the following address:
/Pl{£b
.J¿+)1"",A<:ðY) :;+y'~ - (]ShkC?~ '^
(Address where work will be perfonned)
The nature ofthe work consists of: (Check One or Describe the Nature of Work)
-X.
Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate pennit.
Reconnection or new circuit for the replacement of other pennanently wired
appliances / fixtures.
New circuit for the addition of AlC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value ofthis work is ~4'~ 6<;;¡..,*~_oo
I hereby verify this work will be perfonned by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
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.J<,n Ü ~ ..--y') it ß ~-ß~.-<J )
(Signature of Company Officer)
Kr' '^",.-, .j.'('húla.<...
(Print Name of Officer)
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'(Date)
5/02