HomeMy WebLinkAbout0095252-HVAC (furnace & a/c)
e
OSHKOSH
ON THE WATER
~
CITY OF OSHKOSH
No
95252
HVAC PERMIT - APPLICATION AND RECORD
Job Address 527 MADISON ST
Owner JOANNE E HESS
Create Date 06/19/2002
Contractor RASMUSSEN'S HEATING & AlC INC
Fuel 1"'1 Gas UOil
System D New
~ Forced Air U Radiant
L I Electric I I Hot Water
Chimney Type . Chimney A C) Chimney B
Heat Loss D As Approved . Existing
BTU Rate D As Per Plan () Variable
Category 502 - Residential-Both
U Electric
~ Replace
U Steam
I I Suppl.
C) Direct Vent
Plan
I Solar U Solid
o Other
~ AlC U Vent
1 I Con. Burner
C) Not Applicable
() Not Applicable
. Other
Value 0
Value 80m btu
Use/Nature SFRI Replace furnace & add new a/c. *EIV form from Slim's Electric.
of Work
.
Fees: Valuation
$5,531.00
Plan Approval
$0.00
Permit Fee Paid
$89.00
Issued By:
\..{ VV'
Date 06/19/2002
D Permit Voided I
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
--
~/-., ~ ~
fL- .'... .....
~
~glH
City of Oshkosh
Division ofIuspection Services
215 Cbureh Avenue
PO Box 1130
Oshkosh WI 54903-1130
Offi~e 920-236-5050
Fax 920-236-5084
Electric Installation Verification
I (We)
S' I i )"Yl1.s E leci-r, c:..
(Electrical Contractor Name)
~~D8 Oa..kv.;-ocd. Cv-
(Address)
DshkdSh
(City)
\..J I
(State)
5"4 ttlJ'-I
(Zip Code)
have been contracted to perform electric installation work for _R e..s ltl't u s>s c:..h \ ~ H.YA..'-
(Name of party contracted to)
at the following address:
S;2 7 M "'- J.... \ SCh
. (Address where work will be performed)
The nature of the 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, alter~tions to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of AlC to an individual dwelling unit (house or the
individual systems in a duplex or condonrlnium), including required service
electrical outlets.
Other
The value of this work is $
300
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection I installation will be done in compliance willi manufacturer and Electric code
requirements.
~
0jJ~/O;)-
(Date)
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
O~OJH
ON THE WATER
HVAC PERMIT APPLICATION
All infonnanon after bold categories must be provided.
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- J 128. Connnencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater~
OR
I o. are a contra tor artici in in t Permi e s heck here
if ~ou want this processed throuf!h vour account n
DATE ~ "'lfJ~CJ';)..
JOB ADDRESS 5~ 7 Mtld,:so~
OWNER ThA.l\-c..her Pet+c.rSaY"'\
CONTRACTOR Ro.$~\I~sc::.1'\' ~ f-\VAL.
CHECK IiI ALL APPLICABLE
USE CATEGORY
ilSingle Family ODuplex OMulti-Family
OReotal
OCommercial
DIndustrial
FUEL
.Gas
DOil
DElectric DSolid
DSolar
SYSTEM
ONew
DOther
ttlRepla:ce
TYPE
DtForced Air DRadiant DSteam CliVC DVent OElectric DHot Water DSuppl.OCon. Burner
ISCBIMNEYBEINGLINED DNo (XYes -LINERSIZE 3" &MANUFACTURER Fl~; I.' l'-ter-
Note: All chinmeys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
)&Chimney A
DAs Approved
DAs Per Plan
DChinmey B
t!Hxisting
DVariable
DDirect Vent DOther
DNot Applicable
OOther Value S6J DOO 1:>110
DESCRIPTION OF ALL WORK BEING DONE Rq3\",\~ CUrnA.l.e- o.........d... ~.,.~ A/~
VALUE (Including labor and all materials including light fixtures) $ 6" S 3/
ELECTRICAL CONTRACTOR 51 \ M '~
OR ~Ieetric: Installation Verification form attaehed(lfRepJacement)
Electrical instill/alion ofnewlreplacemenr equipment shall be done by licensed comrade