HomeMy WebLinkAbout0100041 HOSHKOSH
ON THE WATER
.lob Address 209 W PARKWAYAVE
Contractor ADONIS HEATING AND COOLING
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner HARTWELL D WEIDEMANN JR
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100041
03/04/2003
Other J
Vent J
Use/Nature SFR/Furnace replacement, 60,000 btu 92.6% efficient Goodman furnace.* EIV from Seckar Electric
of Work
Fees: Valuation
Issued By:
$2,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$35.00
Date 03/04/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W2707 County Rd H Pine River WI 54965 -0
Telephone Number
685-0458
OSHKOSH
ON THE WATER
.lob Address 209 W PARKWAY AVE
Contractor ADONIS HEATING AND COOLING
Fuel
System
L~d Gas I
~}_ New
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner HARTWELL D WEIDEMANN JR
Category 500- Residential-Heating & Ventilating
bd oil I L~ Electric I [] Solar
j [] Replace j
L~ Forced Air I [~ Radiant I L_I Steam J LJ NC
[~ Electric I L~ Hot Water I LI Suppl. I bd Con. Burner
Chimney Type ~ Chimney A ~,~ Chimney B ~I Direct Vent ~,~ Not Applicable I
Heat Loss ~,~ As Approved ~,~ Existing O Not Applicable I Value
BTU Rate ~.~ As Per Plan O Variable ~t Other I Value
No 100041
Create Date 03/0412003
Plan
1 b~ Solid
[] Other
LJ Vent
Use/Nature SFR/Furnace replacement, 60,000 btu 92.6% efficient Goodman furnace.* EIV from Seckar Electric
of Work
Fees: Valuation
Issued By: ~
$2,000.00 Plan Approval $0.00 Permit Fee Paid
[] Permit VoidedI
$35.00
Date 03/04/2003
In the performan~s work~/ree)t~rk pursuant to rules governing tl~e described construction.
Signature //~"~'¢~ ,~ ~/~~" Date
y 'y ' ~ f Agent/Owner
Address W2707 County Rd H Pine River WI 54965 - 0 Telephone Number
685-0458
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
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 Wl 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
l£ vou are a contractor participating in the Permit fee Account System and have adequate _funds, check here
([ Vou want this processed through your account
JOB ADDRESS
CONTRACTOR ~} 0~ ' g kf~'/,/~ T'-r/ob o'-(.J OO L !/J ~
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
.~ngle Family FIDuplex
[] Multi-Family
l-IRental []Commercial •Industrial
FUEL ~tGas FlElectric F1Solid SYSTEM FINew ,l~Replace
[]Oil •Solar F1Other
TYPE
dS;tForced Air r-lRadiant F1Steam F1A/C []Vent FIElectric
IS ci-imm ¥ BEING LINm) reno i es - LrN-ER SIZE
Note: All chimneys shall be sized per the'~'* "BTU's being vented.
[]Hot Water FISuppl.
& MANUFACTURER
F1Con. Burner
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[] Chimney A
[]As Approved
[]As Per Plan
•Chimney B
[]Existing
F1Variable
. ~irect Vent
121Not Applicable
[]Other Value
[]Other
DESCRIPTION OF ALL WORK BEING DONE /CU/~tu~gct ~fA/,fd£
VALUE (Including labor and all materials including light fixtures) $ O~
ELECTRICAL CONTRACTOR 51~ C ~<'/~ 0t~
[] 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.
9/02
FROM : FAX NO. : Sep. 22 21~2 05:33AM P1
Electric Installation Verification
(Ad,ct~) (City') ($~) (Zi~ Co~¢)
,L-,~dr~ where wo;'~
· The namm ofvhe w~rk ccn~is~.s off (Che~k One or Describe the Nature of Work)
.
~ecormection or new circuit for replacemen~ Heating Plm~.t and'or A,,'C Condemn,
~r~octior. or new circuit tot' r~htcemem ~lectric Wa.'.e: Heater or power vetoed
water heat~.
~teconuectio~ of thc Service ~trance Cable, Meter Box, alterations u~ n~p~c~es
and IiShtln$ ~ixmrcs due to sidin~ / sof~t ins~-,ion. ~ote: New Scrv~
l!ntra~e Cables mis req~/re s aeparato portals,
l~ectJou or now circuit for the replacement of or.h~ permanendy wired
'---- iudi¥idual systems in a duplex or condominium), iv~udi~{~ ,~quited ~er~c-_
Oh'~Z Nm~ of Offic,~') (D~)