HomeMy WebLinkAbout0086990-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 803 MICHIGAN ST
CITY OF OSHKOSH
No
86990
HVAC PERMIT -APPLICATION AND RECORD
Owner KELLY J BURNETT
Create Date 06/20/2001
Contractor MONROE HEATING & COOLING LLC
Fuel 1,1'1 Gas I Oil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type KJ Chimney A () Chimney B
Heat Loss () As Approved . Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
I Electric
o Replace
U Steam
U Suppl.
. Direct Vent
L J Solar I Solid
D Other
U AlC U Vent
U Con. Burner
() Not Applicable
C) Not Applicable
() Other
Value
Value
Use/Nature ::>FR / REPLACE FURNACE IN HOME
of Work No electric permit required - received installation verfication signed by Seckar Electric)
Fees: Valuation $2,000.00
Issued By: 0(1') S
Plan Approval
$0.00
Permit Fee Paid
$35.00
Date 06/22/2001
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 2527 BOWEN STREET
OSHKOSH
WI 54901 - 2021
Telephone Number (920) 232-6838
.. 1 -09-1995 0: 16AM
FROM
P.2
~
~
Pivision of xn8pe~tian Sc~1cc.
21.S Chu.rch Av__
P.O. Box 1130
oshkoall. WI 5'9t)3-1130
Fax . 1"0) 2~'-S084
PhoDe (920) 236-504&
HVAC PBRMIT APPLICATION
All fields/information after bol~ cacegories must be provided.
Incomplete application8 will not be processed.
DATH
JOB AVDRKSS ~O__'g. "t1ll,'c..1v q q~1 a~
- a~ .Slt~
00IITRAC'r0R---- E =-<L:: {fMt;'J'
CIRCLB ALL APPLICABLB
USB CATBGORY ~NGLE FAMILY
PUKL ~
DUPLEX
MULTI-FAMILY
COMMERCIAL
INDUS'1'RIAL
OIL
ELECTRIC
'~PLACE
SOLAR
SOLID
SYSTBM
NEW
\P()~CED AIR
OTHER
ELECTRIC
RADIANT
HOT WATER
STEAM
Ale
VENT
TYPE
IS CHI~ 8BXBG LrRBD LINER SI~E
Note: All chimneys shall be sized per ehe BTU's being vented.
SUPPL.
41(
CON - BURNER
MANUFACTURER
cal..Y TYPB
CHIMNEY A
CHIMNEY B
'-€'XIS'l'ING
VAR.IABLE
'"DIRECT VENT
OTHER
RlIAT LOSS
BTU RATB
AS APPROVED
~ PER PLAN
NOT APPLICABLE
OTHER VALUE
IfATfJRB 0" WOlUt: I
f-e fJlc...,1':'~L_. nL-~-' ...)CD ~'i-\..JL..
VALUB (Includlnsr lUOi- aDd materials) $ ,? /XX:). en
ELBC!'RICAL COln'RAC'l'cs. . ~~ ~ ~" .
F-1~ctrical installation of new/replaeemen~ ~quipment shall be done by licensed
contractors.
valuation Fees
$0 to $1.000. 00.__.___.._.____....__.._...._._._._._."._.___.._.__.._________.._._..$20.00
$l. 000.01 to $10.000. 00.._.__....._........_._._._.__.__._....._..._______ _.$20.00 for first
$1,000.00 plus $l.50 per $100.00 valuation or part thereof
$10,000.01 to $25.000. 00_____.._._._.__..........._._....__._______..___..______.$155.00 for first
$10.000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25.000. OO..___._._".r._._._.__......_._....~........._._._.._....__~._._.________._._.__$305 _ 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 $100.00 plus the normal permit fee. which ever is.
greater.
"Jlt: -: ~, ...
FROM SECKAR ELECTRIC
FAX NO.
9202313950
Jun. 19 2001 02:30PM P1
~
OIHI<OIH
0,.. ''''E WA.TER
City or O.hJco.h
Divi&ion of lll5p<ction Sl!rvice$
215 Cburch Avenue
PO Box 1130
O.l1ko.." WI S4~02-ll ~Q
Office 920.236.5050
Fill 920-236-5084
Electric Installation Verification
(1) (We) ~eckAr Electric Company Inc.
(Electrical Contractor Name)
5920 Courtney Plummer Road, Winl1econne, Wisconsin 54986
(Address)
(City)
(State)
(Zip Code)
have been contracted to perform electric installation work forMonroe Heating and Cooling
(Name of party contracted to)
803 Michigan Street
at the following address:
. (Address where work will be performed)
The naturcX wort< consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or NC Condenser.
Reconnection or n~ circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding I soffit installation. Note: New Service Entrance
Cables will require a separate permit. .
Reconnection or new circuit for other permanently wired appliances I fixtures.
Other
The value of this work is $ f 2 :;: . 0 a
I hereby veri fy this work will be performed by an employee of this company and further verify the
reconnection / instalJation will be done in compliance with manufacturer and Electric code
requirements.
1 (/.~ I
Dia~ R Seckar
JUNE 19, 2001
(Print Name of Officer)
(Date)