HomeMy WebLinkAbout0097732-HVAC (furnace & a/c)
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OSHKOSH
ON THE WATER
Job Address 1210 HARNEY AVE
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner BETTY J V ANDERSEE
Contractor RASMUSSEN'S HEATING & AlC INC
Fuel ~ Gas I Oil
System o New
l!J Forced Air U Radiant
I I Electric I I Hot Water
Chimney Type K) Chimney A . Chimney B
Heat Loss K) As Approved . Existing
BTU Rate K) As Per Plan C) Variable
Category 502 - Residential-Both
U Electric
I Solar
o Replace
U Steam l!J AlC
U Suppl. I I Con. Burner
() Direct Vent () Not Applicable
C) Not Applicable Value
. Other Value
Use/Nature ISFRI Replacing furnace & adding A1C. *EIV form from Slim's Electric.
of Work
No
97732
Create Date 10/03/2002
Plan
U Solid
o Other
U Vent
o
60m
Fees: Valuation
Issued By: K \(\1\
$4,730.00
Plan Approval
$0.00
Permit Fee Paid
o Permit Voided I
$77.00
Date 10/03/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Agent/Owner
Date
WI 54904 - 8850 Telephone Number 920-235-6569
Address
5154 DAVID DR
OSHKOSH
-,
CityofOsbkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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OJHKOfH
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 YOU are a contractor participatinf! in the Permit fee Account Svstem and have adequate funds. check here
if YOU want this vrocessed throu~h your a.c.countn
DATE '1'- 30 '02.
JOBADDRESS /:1/0 Ho.i'ne..y AVF
OWNER Be-ttj V lA.\'\du See:..
CONTRACTOR Ro..&Wtvssc.V\'s NvA""
CHECK 6ZI ALL APPLICABLE
USE CATEGORY
&!ISingle Family ODuplex OMulti-Family
ORental
OComrnercial
DIndustrial
FUEL
I2roas
DOil
OElectric DSolid
DSolar
SYSTEM
DNew
DOther
I2tReplace
TYPE
lXForcedAir DRadiant DSteam [8.AIC OVent DElectric DHotWater DSuppl. DCon. Burner
IS CHIMNEY BEING LINED ONo O!IYes - LINER SIZE :3 Ii & MANUFACTURER -f: 1-(:. v. i \ 11-\ (,r
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
OAs Approved
DAs Per Plan
riChinmey B
Ii1Existing
DVariable
DDirect Vent Dbther
DNot Applicable
18l0ther Value ~O, (n()
DESCRIPTION OF ALL WORK BEING DONE RepI6LI.n~CVfiu..~ of- a..Jc\,~~ A-fl
VALUE (Ineluding labor and an materials including light fixtures) $ i./.7 30
,
ELECTRICAL CONTRACTOR S h I'VI ;-s E } c..t..A-r I 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 InstallatioD Verification
w\ 5'~fa4
(State) (Zip Code)
have been contracted to perfonn electric iDstaUItionwork for 'R~G~vsset\'~ HvA'-,
(Name of party contracted to)
l:7.j() Ha.(f\ey Ave..
(Address where work will be performed)
aa68
(Address)
$/iWl'~ EJcc,+r,<:...
. (Electrical Contractor Name)
O(i..kwctd e." Oshkosh
(City)
I (We)
at the following address:
The nature oftbe work consiSts of (9heck One or Describe the Nature of Work)
_ Reconnection or new circuit b replacement HeatiDg Plant audlor Ale Condenser.
_ Recom1ection oraew circuit for replacement Electric Water Heater or power vented
water heater. .
_ Reconnection otthe 8ervipe Bntrance Cable, Meter Bo~ alterations to receptacles .
and lighting fixtures due to siding I softit h1stalIation. Note: New Service
Bntnmce Cables '\Vill require a separ.ate permit
_ Reconnection or new circuit for the replacement of o1her permanently wired
appliances /fixtures. .
-L New circuit fur the addition of AIC to an intltvIdutil dwelling unit (house or the
mdiv.iduaJ"8)'8teIIW"in a duplex: or~um), iDc1uding.required serrice
e1ectr.ical outlets.
_ Other
The value of this work is $ 3 50. 00 .
I hereby verifytbis wmk will be pgCottclecl by an emploJee ofdUS compauy aud:fiuther verify
the reconn.ec:Iion I jqJnnBtion wiD be done in ~ with IIl8II1Ifilctut and mectric code
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