HomeMy WebLinkAbout0102639-HVAC (furnace & A/C)OSHKOSH
ON THE WATER
JobAddreee 1639SHERIDAN ST
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
AMERICAN HEATING & A C CO
[] New
k~J Forced Air
I IElectric
Oil
Radiant
u°twater
Owner STEVEN L/ANN M STEINERT
No 102639
Chimney Type
Heat Loss
BTU Rate
Chimney A
As Approved
As Per Plan
Create Date 07/03/2003
Category 502 - Residential-Both Plan
~J Electric I ~r- Solar 1 ~- Solid 1
~-] Replace I [] Other ]
LJ Steam I I~ NC ~1 Vent
] ] Suppl. ] LI Con. Burner I
Chimney B O Direct Vent ~) Not Applicable J
Existing (,.2 Not Applicable J Value
Vadable O Other I Value
0
45m & 24m NC
Use/Nature
of Work
~FPJ Replace 75m
btu furnace and add 2 ton central NC. *EIV form from Seckar Electric.
Fees: Valuation
Issued By:
$4,000.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided
$65.00
Date 07/03/2003
In the peEormanceofthiswork, I agree to pefformallwork pursuanttomles governing the described cons~uction.
Signature Date
AgenFOwner
Address 1129 MICHIGANAVE OSHKOSH WI 54902 -6437 Telephone Number (920)235-8090
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLIC "Fi D£ ' ,
All info~ation after bold categories must be provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City ttall, 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 partic_i.p_atin~g_in the_.._P_?rz~it fee Acco~£n~ System and have adequate funds, check here
if vou want this processed throu~y_o~ur a_.ccp_Lt~t~
DATE
OWNER
CO TRACTOR
CHECK [] ALL APPLICABLE
CATEGORY
ngle Family F1Duplex UIMulti-Family V1Rental V1Commercial [2]Industrial
FUEL [~as [2]Electric F1Solid SYSTEM I-INew JSl~eplace
UlOil UlSolar r-lOther
TYPE
~-orced Air UlRadiant DSteam~VC U]Vent E]Electric f-tHor Water DSuppl.r"lCon. Burner
IS CHIMNEY BEING LINED UNo ~es - LINER SIZE ,.~_2~ & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented,
CHIMNEY TYPE
HEAT LOSS FIAs Approved ~xisting
BTU RATE l-lAs Per Plan UlVariable
DESCRIPTION OF ALL WORK BEING DONE
F1Chimney A V1Chimney B ,[~4:3irect Vent ClOther
FINot Applicable
ther Va ue VC ' -- Z o-o-o
-
VALUE (Including labor and all materials including light fixtures) $ . ~-
ELECTRICAL CONTRACTOR OR~,glectric Installation verification form attached(If Replacement)
Eledrlcal installation of new/replaceraent equipment shall be done by licensed contractors.
3/02
Electric Installation Verification
(we)
(Electrical Contractor N~e)
(address) (City)
have been contracted to perform electric installation work for
at the following address:
(State) (Zip Code)
(Name of party contracted to)
(Address where work w/Il be performed)
The nature of the work consists of.' (Check One or Describe the Nature of Wo~k)
~ Recormection or new circuit for replacement Heating Plant and/or A/C Cond~kqcr.
Reconnecfion or new circuit for replacement Electric Water Heater or power vented
water heater.
. , Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
........ New circuit for the addition of MC to an individual dwelling unit {house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $.
I hereby verify this work will b~ performed by an employee of this company and further verify
the reconnection / inztallation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
-2a
(Date)
5/O2