HomeMy WebLinkAbout0097442-HVAC (furnace & a/c) CITY OF OSHKOSH "0 972
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2312 JEFFERSON ST Owner JOAN M STRAVELER Create Date 09/20/2002
Contractor RASMUSSEN'S HEATING & A/C INC Category 502 -Residential-Both Plan
Fuel / Gas Oil Electric Solar Solid
System ^ New ~ ^/ Replace ^ Other ~
/ Forced Air Radiant Steam / A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value 0
BTU Rate As Per Plan Variable Other Value 60m
Use/Nature
of Work
~EIV form from Slim's Electric.
Fees: Valuation $5,350.00 Plan Approval $0.00 Permit Fee Paid $86.00
Issued By: ~~ Date 09/20/2002
^ Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Address 5154 DAVID DR
Agent/Owner
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O.lHKO H
ON THE 1NATER
• 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 $1-00.00 plus the
normal permit fee, which ever is greater.
OR
JOB ADDRESS ~ 3 ~a '.~ ~' ,-~,~
OWNER LYnnG /~( ~tLl^cl~
CONTRACTOR ~(usr~ ~s~ Win' ~ h(V/kC.,
CHECK B ALL APPLICABLE
USE CATEGORY
Single Family ^Duplex ^Multi-Family
FUEL f~,Gas ^Electric ^Solid
^Oil ^Solar
DATE ~-/~ -C~ ~
~~ ~ , ~
~~~N~ - ~
~,~°,~E17MEfv~ ~_,;~
..;
^Rental ^Commercial
SYSTEM ^New
^Other
^Industrial
[$Replace
TYPE
.Forced Air ^Radiant ^Steam jg(A1C ^Vent ^Electric ^Hot Water ^Suppl.^Con. Burner
IS CHIMNEY BEING LINED {~No ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTtl's being vented.
CffiMNEY TYPE ^Chimney A Chimney B ^Direct Vent ^Other
HEAT LOSS ^As Approved [$~Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable 1~Other Value ~~',Ci~~
DESCRIPTION OF ALL WORK BEING DONE KCi~1~AG in' -3'~r,~w~L an~,~ ~(~
VALUE (Including labor and all materials including light fixtures) $ ? ,~ ~~1. ~~
ELECTRICAL CONTRACTOR OR Electric Installation Verification form attached(If Replacement)
Electrical instgl,(nlion of new/replncement equipment shall Ge clone by licenser! conrrnclors.
nsc~s~
rearRu~s
a+r~~u Ewa-ino
O~Ioa'J@~.2l6.9~90
~Q,,, ,~ - E3ot 1~6.S~t
Electric Installation ~Ver>~fiication
T(We) S~il'n 5 ~~~+r+t
(Electrical Coxmractor Name) ~
Oc~O~CJ ~6~kw~l Cr ~ShkoS~ t.v~ `~ 71Q~
(Addreess) (city) (state> (zip coca)
have been cow to perform electric installation work for IQaSyn~sser'S H1[A ~-- ,
(Name of party contracted to)
at the following address: _ ~ ?~ i a- "S ~,~~~c: sa n
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circmit fear replacx~ent Pleating Plant ad/or A/C Condenser.
Ramon or new circuit for replacement Electric Water Heater or power vented
water heater:
Ration o~the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting ~ due to siding / soffiit installation. Nate: New Service
Entrance cables will require a sepffiate permit.
Reconnection ar new cinuit for the replacement of other permanently wired
appliances / fixtures.
New cir~rit for' the addition of A/C to an iddividual dw~elli»g unit (house or the
individual ~sy~ng~in a duplex or c~dansiiriu~n), including required service
electrical outlets.
Other
The value ofthis work is $ ~ ~. ~
I hereby verify this woslr w~l be p~~tormed by an esnpjoyee of this co~any and further verify
the reconnection / a~ will be done im co~pliaocx with n~rer sad Electric code
a -,
~~ ~ ~~ , ~