HomeMy WebLinkAbout0081323-HVAC (A/C)
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OSHKOSH
ON THE WATER
Job Address 1852 HUBBARD ST
CITY OF OSHKOSH
No 0081323
HVAC PERMIT - APPLICATION AND RECORD
Owner
JOHN P MUNDINGERlC RATCHMAN
Create Date 09/18/2000
Contractor CUSTOM HEATING
Fuel I J Gas I J Oil
System o New_ I
U Forced Air U Radiant
I J Electric I I Hot Water
Chimney Type K:) Chimney A U Chimney B
Heat Loss U As Approved () Existing
BTU Rate KJ As Per Plan ( ) Variable
Use/Nature SFR /INSTALL 2 TON AlC
of Work
Category 501 - Residential-Air Conditioning Plan
I I Solar I Solid
o Other
~ AlC U Vent
I I Con. Burner
U Electric
0_ ~eplace
U Steam
I I Suppl.
() Direct Vent () Not Applicable
C) Not Applicable Value
() Other Value
,
Fees: Valuation $1,350.00
Issued By: 3'{\[\ <)
Plan Approval
$0.00
Permit Fee Paid
$26.00
Date 09/21/2000
o 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
1503 S. MAIN ST.
OSHKOSH
WI 54902 - 0
Telephone Number (920) 235-7263
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Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 235-5084
phone (920) 236-5048
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HVAC PERMIT APPLICATION
All
fields/information after bold categories must be prov
Incomplete applications will not be processed~
DATE 'I
JOB ADDRESS ~ /tv"""J/""ilen.
OIlNBR /, !5:S;? 7f; b&~ c/
CONTRACTOR C!a~fl ftep. /~
CIRCLE ALL APPLICABLE ~
USE CATEGORY ~ DUPLEX
FUEL GAS OIL ELECTRIC
MULTI-FAMILY
SOLAR
COMMERCIAL
SOLID
INDUSTRIAL
SYSTEM
NEW
REPLACE
OTHER
TYPE
FORCED AIR
RADIANT
STEAM
@ VENT
CON. BURNER
ELECTRI C
HOT WATER
SUPPL.
IS CHIMNEY BEING LINED LINER SIZE
No~e: All chimneys shall be sized per the BTU's being vented.
MANUFACTURER
CHIMNEY TYPB CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTU RATB AS PER PLAN VARIABLE OTHER VALUE
NATURE OP WORK: ::;~ a-c::- AF
0-0
VALUE (Including labor an~dt. rials) $ I',~
ELECTRICAL CONTRACTOR . €,u-pe."
Electrical installation of ne Ireplacement equipment shall
contractors.
be done by licensed
Valuation
Fees
$ 0 to $1, 0 0 0 . 0 0 ..-.......-.........................................................._......._..................................................... $ 2 0 . 0 0
$1 , 000 . 01 to $10, 000 . 0 0 .................................................m..............................._......................_..$ 20 . 0 0 for firs t
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$101 000 . alto $ 2 5 I 000 . 0 0................................................................._.........................................$155 .00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Ove r $ 25 I 000 . 0 0 ...........-................................................................_..............................._.......................$ 3 0 5 . 00 plus $ 0 . 50
per $100.00 valuation or part thereof
· Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
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GJH<OIH
ON THE WATER
City of 0shIr0sh
Division of Inspection Services
21 ~ Chun:h Avenue
PO Bo" IlJO
Oshkosh WI 54902-1130
Office 920-236-S050
Fax 920-236-5084
(I) (We) Y1 l.:"L,.eG
I (Electrycal Contractor Name)
I c}/ IZ.. O.l1r-~ bJ'l1)Za. ~( z:: i4is
I (Address) (City) -(State) (Zip Code)
- hle been contracted to perform electric inStallation work for -. Sldfrt ;J-(>/l-J/ n
[ - . .- '- . I - (Name of party contracted to
atllthefOllOwingaddres':Zff~ ~ :;r
I (Address where work will be performed)
I
~e nature of the work consists of: (Check One or Describe the Nature of Work)
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stallation -V-erifi-eation
Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection-{)fthe Service Entrance Cable, MeterBox, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
- Cables wilt require a- separate permit.
Reconnection or new circuit for other permanently wired appliances I fixtures.
Other
I
The value of this work is $ /{)u.-lJJ
I hereby verify this workwillbe performed by an employee of this company and further verify the
reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
(PriIitName of Officei-)
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