HomeMy WebLinkAbout0084470-HVAC (furnace) CITY OF OSHKOSH No saa~o
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 928 COZY LN Owner CATHIE M KISSINGER Create Date 02/05/2001
Contractor RASMUSSEN'S HEATING & A/C INC Category 500 -Residential-Heating & Ventilating Plan
Fuel as i ec nc ~ oar o i
System ew ep ace er 1
orce it a ian eam ~ en
ec nc o a er upp . on. urner
Chimney Type imney imney irec en o pp ica e
Heat Loss s pprove xis ing o pp ica a Value
BTU Rate s er an ana a er Value 60,000
Use/Nature
of Work
FR7 _ ___
Vo electric permit required-received installation verification signed by Seckar Electric)
Fees: Valuation
Issued By:
$3,660.00 Plan Approval $0.00
ermi of e
Date 02/28/2001
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Address 1915 KNAPP STREET
Agent/Owner
OSHKOSH WI 54902 -6612
Permit Fee Paid
Telephone Number (920) 235-6569
$60.50
7-13-1996 9:diPM FROM RASMUSSEN S HVAC IN 920 235 36d2 P.1
GivisioA of IneBection Strvicea
215 Church Avenue
P.O. Sox 1130
Oshkosh, WI 54903-1130
N.~. w^ e. Fax M 1920) 236-5084
Phone t920) Y36-5048
HVAC PTRMIT APPLICATION
All fieldsjinformation after bold categoriea~muat be~.provicted.
Incomplete applications will not be processe,i.
JOB ADDRESS ~ \ ~ 3 ~ ~` ~ ~ ~ N-Q„_
OWN$R ~ /4~ ! ~ Cam.. S S ~ t-~C'o-E..Y~, .
corrrRacTOR~~~./~-S v~ ~.~s .s ~ ~ ,o ~- t,/ p- C1 ~~`-~C_.
CIRCLE ALL APPLICABLE
USE CATEGORY SIB E FAMILY DUPLEX MULTI-FAMILY COF4MERCIAL INDUSTRIAL::
FIIEL ~~ OiL ELECTRIC SOLAR :30LID
SXSTEM NEW )$PLA OTHER
TYPE FRO CED AI IANT STEAM A/C VENT
ELECTRIC HOT AATEK SUPPL. CON. BURNER
i~
IS CHII~TSY BgING LINBA U'` .:~ ~ LINER SIZE ~ PIAN[JFACTURER (fix , ~ , ++ •~; ~
Diote : All chimneys shall be~ sized per the BTU's being vented,,.- .. -- ._...__ _.._ ..,
CHIMrTSY TYPE CHIMNEY A CHIMNEY B ~/DIRECT VENT) OTHER
HEAT LOS$ AS APPROVED" EXISTING- NOT APPLICABLE
BTU RATE- AS PER PLAN VAI~IAflF~E OTHER VALUE
NATIIRB OF WORK : 6C'! ~~ l~~-a . ~-'~~1:.~ M.qc-C~,
VALUE (Including labor ar~~is~aterial.•s~ $ 3~~a~ a~
ELECTRICAL CONTRACTQR g;~.E.1~ •
Electrical installation of new replacement equipment shall be done by licensed
contraCCOrB.
Valuation Feea
$0 to $1, 000 - 00 ............................._....
$I, 000.02 to $10, 000. 00....._._._ ............._........».................--•---. ,..._..............................._.......$20.00 r t
fo firs
$1,OQO.00. plus $Z, SO per. $1~OU.00 valuetion or part thereof
510, OOO _ O1 to $25, 000.00...,.,.....» ...................................................- .............................$155.00 for first
$20,0.00.00 plug $1.00 per $100.QO.valuation or part thereo€
Over $ 2 5, 0 0 0 .0 0........__-_.........»..„„„w.,..._„_,,.»,„ ................................_._._....,..,._. - .._.$3 0 5.0 0 plus $ 0.5 0
per $100.00 valuatio~cl or part thereof -
• Submit payment w%th application. Failure tc pay Within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, ++thich ever is -
greater.
7-13-1996 9:diPM FROM RASMUSSEN'S HVAC IN 920 235 3642
l
Ciryofdshkosh
trv,x,on of Inspection Services
Z I S Chspcb Avenue
PO t3ox t t SO
O:hlcosh Wl St902• t ! 30
011-~C~JIH Office 920.2365060
ON TnE WATER Faa 420-I1~588d
E~eea~ri€ hllt~talla~ion ~ V~erifkea>~~eu ~ :
(Electrical GornractarNatne)
(City)
(State} (Zip Code)
P. 2
have been contracted to perfornn electric installation work. foi ~ ~~ ~`'~' S ~ tip ~U AC '~ '~~'~`~-~
(Name of party co:ztracted to)
at the following address: ~~ ~ ~ ~~~ ~ 1--~ ~~ ~- .
(Address where work
be per~'ormed)
The natvze of the work consists of : (-Check (lne or pescribe the Nahue of Work)
~`
reconnection or new circuit for acemem'Heating-Pl anchor A/C Condensex_
Reconnection or new circuit for rep ace ec c titer Heater. '
Reconnection of the Service~Ei7tranee Cabli°;1Vretter$ox; alterations to receptacles and
lighting fixtures due to siding / sof£tE ittstallati~ Note: Flew Service 1/ntrarace
Cables will require a separate permit.
ReconnectizDa:or:neYV ci>~~~ permaaentky.wired:ap~liaxes /fixtures.
Other
The value of this work is ~ , ~~_a~ -
thereby verify this work will be performed by a~ em~yee.of.th~:company and further verify the
reconnection /installation will _be done incompliance with manufacturer and Electric code
requirements.
~,
(Signat ie`~of ~mpany Officer)
(Print Name of Offcex)
\ t b t, ~
(Date)