HomeMy WebLinkAbout0099743-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address 827 GRAND ST
Contractor ANDRESEN SHEET METAL
Fuel ~ Gas I
System [] New
Chimney Type
Heat Loss
BTU Rate
Use/Nature
of Work
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air
Electric
Owner M E LAWRENCE ETAL
Category
[] Oil ] [] Electdc
I [] Replace
~_j Radiant I ~ Steam
I I Hot Water t M Suppl.
Chimney A F_~ Chimney B ~1~ Direct Vent
~ As Approved ~i Existing
~ As Per Plan ~ Variable
500 - Residential-Heating & Ventilating
Solar
~ NC
[~ Con. Burner
~.~ Not Applicable
Not Applicable t Value
Other I Value
SFPJ Furnace upgrade. *EIV form from Arrow Electric.
No 99743
Create Date 02/10/2003
Plan
[] Solid
[] Other
b--J vent
Fees: Valuation
Issued By:
$2,300.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided J
$39.50
Date 02/10/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described constructiOn.
Signature Date
Agent/Owner
Address 2913 WITZEL AVE 'OSHKOSH WI 54904 -6539 Telephone Number
(920) 233-0323
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
FEB 1 0 2003
DEPARTMENT OF OJ'HKO/H
HVAC PERMIT APPI. ICATI n
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 $100.00 plus the
normal permit fee, which ever is greater.
I_f you are a contractor participating in thd Permit fee Acdount System. an:~l: hCtve' ade!q~ate funds['bh~ck here
(f you want this processed_through your a~coftnt_ ['7] ' ' ''
SYSTEM F1NeTM '~lace
F1Other '
EiHot Water' []Suppl. EICon. Burner
& MANUFACTURER~/5~c~
EIOil EISolar ~ ,.
TYP .
~Air EiRadiant ~FlSteam'FIA/C EiVent []Electric
IS CHIMNEY BEING LINED EINo [~es - LINER SIZE ,~/¢
Note: All Chimneys shall be sized per the BTU's being vented.
[]Chimney A ~x~s-r~y B E~irect Vent EiOther
[]As Approved EINot &pplicable
[]As Per Plan []Variable I;]Oth~er Value
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DESCRIPTION OF ALL WORK BEING DONE
(~[ncluding labor and all materials including light fixtures)$ ~.~',.~6''-~) '
VALUE
~:, "~
ELECTRICAL CONTRACTOR
B 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.
. EROH,~: AR~ ELECTRIC PHONE HO. : 921~42G4220 Feb. 04 2003..01:17PM P1
(We).
(£1ect~cal Comractor Name)
Electric Installation Verification
"' (Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for ~.~L,,s:~,., $/~-{- r-~t_ (n. (
(Name of party contracted to)
at the following address: ~',~"/ ~'~c' ._<:::'-~-"'
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
ff,,~.. Reeormection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Rcconncction of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to'siding / soffit installation. Note: New Service
Entrance Cabl~ will require a separate permit.
~ Reconnection or new circuit for the replacement ofother permanently wired
appliances I fixtures.
New circuit for the addition of MC to an individual dwelling unit (house or the
individual sy-~tem.~ in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ /0'o,~
I hereby verify this work will be performed by an employee of this company and further verify
the recormection / installation will be done in compliance with manufacturer and Electric code
requirements.
~rint Nam~ of Officer) (Date)
5/02