HomeMy WebLinkAbout0099803-HVAC (furnace & a/c)(~ CITY OF OSHKOSH No
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2415 HERITAGE CT Owner JOHN W WILSON
Contractor AMERICAN HEATING & A C CO Category 502- Residential-Both
Fuel ~J Gas ~ ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m & 24m a/c
Create Date
Plan
~J Solid
Vent
99803
02/12/2003
Use/Nature SFR/Replace furnace and central a/c. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$3,925.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$65.00
Date 02/12/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number
(920) 235-8090
'City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
'C)./HKO../'H
ON T~F \,V'Ai'FR
· 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participqfing_.in the Permit fee _Accout!_t__Systern and have adequate funds, check here
if you want this processed thr_oF~h your account
USE CATEGORY
[~ingle Family FIDuplex F1Multi-Family
F1Rental
FUEL ~,as FIElectric E]Solid SYSTEM E]New ,~eplace
FIOil F1Solar F1Oth er
TYPE
~[orced Air F1Radiant FlSteam ~/C E1Vent F1Electric FIHot Water IZISuppl. F1Con. Bumer
IS CHIMNEY BEING LINED ~l~fo FIYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CItlMNEY TYPE FIChimney A FIChimney B ¢l~irect Vent F1Other
HEAT LOSS EIAs Approved lii~5-xisting FINot Applicable
BTU RATE F1As Per Plan F1Variable ¢;;t~i!~Other Value
A, L WO..
VALUE (Including labor and all materials including light fixtures) _$ ,.J°~Z~ ~
ELECTRICAL CONTRACTOR ,~'~/~q/-~.- ~ ~ Electric Installation Verification form attached(ffReplacement)
~/~.¢ Electdcnl installation o/new/replacement equipment shall be done by licensed contractors.
3/02
FROH
FAX NO. :
Electric Installation Verification
' "t c-rcrc (_.o /
(El~trical Contractor Name)
(Ad~s) (City) (S~t¢) (Zip Code)
have ~m con~ ,o ¢o~ e,~c ',aallafion work for'J~t(~
~ ofp~y con~ to)
'(Ad~e~ where work will be ~~)
~ ~t~e of~e work consism of: (Ch~k One or D~cfibe ~e Na~ of Wo~)
~R~o~g~ or n~ ~t for r~~t H~a~g P~t ~or ~C C~d~.
.... R~o~~ or n~ cim~l for r~l~em~t El~c Water Heat~ or pow~ v~t~
wat~ ~..
R~ti~ o~e S~ce En~ce Cabl~ Met~ Box. ~lemfi~
~d li¢~g fi~ due [o siding / soffit ins~l~o~
~ce ~bles will r~aire a s~te p~t.
.. _ R~o~ion or n~ ¢~uit for ~e r~l~em~t ofo~er P~dy wi~
~l~ces / fixt~.
... New ¢~1 for ~e ad, don og~C m ~ indi~dual ~elling
individ~l s~t~s in a d~lex ~ condo~i~), i~lud~g ~q~
el~d~al oml~m.
Other
The value ofshis Work is
i hereby verify this work will be pon%rmod by an employee of this company and further verily
~he reconnection / inslallation wilt be done in compliance with manufacturer and Eleclric code
requirements.
(Si~gnature~fOoml~Offi~j : ~(PrintN~neofOfficer)'
.~t02