HomeMy WebLinkAbout0097961-HVAC (furnace)
".
OSHKOSH
ON THE WATER
Job Address 722 BISMARCK AVE
CITY OF OSHKOSH
No
97961 '
HVAC PERMIT -APPLICATION AND RECORD
Owner RICHARD G BONACKlDIANE M WEBER
Create Date 10/11/2002
Contractor RASMUSSEN'S HEATING & AlC INC
Fuel ~ Gas UOil
System o New
~ Forced Air U Radiant
U Electric I I Hot Water
Chimney Type U Chimney A . Chimney B
Heat Loss KJ As Approved . Existing
BTU Rate KJ As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
~ Replace
U Steam
U Suppl.
() Direct Vent
I I Solar I Solid
o Other
U AlC U Vent
I I Con. Burner
() Not Applicable
() Not Applicable
. Other
Value 0
Value 40m
Use/Nature ~FRI Replacing furnace. *EIV form from Slim's Electric.
of Work
Fees: Valuation
$5,500.00
Plan Approval
$0.00
Permit Fee Paid
$87.50
Issued By:
K",^
Date 1 0/11/2002
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
5154 DAVID DR
OSHKOSH
WI 54904 - 8850 Telephone Number 920-235-6569
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OJHKOJH
ON THE WATER
HVAC PERMIT APPLICATION
All information 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 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor participating in the Permit fee Account Svstem and have adequate funds. check here
if vou want this TJrocessed through vour accountn
DATE /0.- 8 -CJ ;t
JOB ADDRESS 7$~ 13 j'St'l-lo..r k
OWNER 6eo.("<e, c.. E>o'h,,-c..k
CONTRACTOR RO":~~U";:.5c.Y"S I-lV!+C
RECEIVED
CHECK ~ ALL APPLICABLE
USE CATEGORY
fiQSingle Family ODuplex OMulti-Family ORental
OCT 1 1 2002
DEPARTMENT OF
COMMUNITY DEVELOPMENT
OCommercial o Industrial
FUEL
OOas
DOH
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
mlReplace
TYPE
/;1IJForcedAir ORadiant DSteam DAlC OVent DElectric DHotWater DSuppI. DCon. Burner
IS CHIMNEY BEING LINED DNo lifYes - LINER SIZE 3 1/ & MANUF ACTIJRER F {e~ i I ~ hev
Note: All chimneys sball be sized per the BTU's being vented.
CHIMNEY TYPE
BEAT LOSS
BTURATE
OChinmey A
DAs Approved
DAs Per Plan
l3'Chimney B
IBExisting
DVariable
DDirect Vent DOther
DNot Applicable
ROther Value l/ OJ 000
DESCRIPTION OF ALL WORK BEING DONE R c..piALi "?J ~ ~ V" Y\t:l.~e
~,'~
......< .
VALUE (Including labor and all materials ineluding light fIXtures) $ 5: S 00
.
ELECTRICAL CONTRAcroR S I \ f'l'\ IS E/e~wl'c-
)(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.
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----
Electric Installation Verifieation
I (We)
Slim'~ E'/ce+ri<:...
(Electrical Contractor Name)
OCLkw~ (;..1' Oshkosh
(City)
w\
(State)
5'~ftJ4
(Zip Code)
a~(j8
(Address)
---- havebeen confnactetftopei.tonn electric UifJt8DatimiWOriC for . R ctGmvsset'" 5 H \I A c....
(Name of party contracted to)
7;;l ~ 13 I' ~Eo/1CU'" k.
(Address where work will be performed)
at the following address:
The natme of the work consists of: (Check One or Describe the Nature of Work)
~ Reconnection or new circuit.fbr replacemeut HeatiDgPJant aDdIor Ale Condenser.
~ Reconneetion or new circuit forrepJacement Blectric Water Heater or power vented
water heater. '
_ RecoJ1DeCtion of the Servi~ Entrance Cable, Meter Box, altemtions to receptacles .
and Jigbthlg fixtures due to siding I so:ftit instaUation. Note: New Service
Bnmmce Cables wiD require a separate permit.
_ :R.eccmnection or new cirouit for the replacement of other permanently wired
appliances I :fixtures. .
_ New chcuit tbrthe addition of AIC 10.. iIft1ivItJ.1 dwelling 1I1Iit (house or the
iDdiv.iduat'S)'IIIemSia a duplex: OI'~il.:IDD), iDc1uc1iug~ se.rrice
electrical outlets.
_ Other
The ,value orthis work is $ :;) C(j ,00 .
14=bY verlfythis work wiD be pafuMaed by an employee oftbiScompany and further verify
the~nneetioDl ~n.oon will be doneinc:ompJiancewilh UI8....~ and mectrie code
~p/=dJ
(PIiDt N81Deof
/6- 8-o~
(Date)