HomeMy WebLinkAbout0100241-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 886 HENNESSY ST
Contractor VANS HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CHRISTOPHER L/B MARTIN
Category 502- Residential-Both
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
100241
03/14/2003
Other J
Vent J
Use/Nature SFR/Replace furnace and a/c system. *EIV form from Concept Services.
of Work
Fees: Valuation
Issued By:
$5,116.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$83.00
Date 03/17/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 525 BUTLER ST DEPERE WI 54115 -5426 Telephone Number
(920) 336-2816
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/HKO/H
ON THE WATER
· 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.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
(f vou want this processed through your account []
CHECK [] ALL APPLICABLE
USE CATEGORY
~gle Family ElDuplex
F1Multi-Family
EIRental
FUEL ~G'~s ~ectric F1Solid SYSTEM
[]Oil [3 Solar
DATE
F1Steam~C []Vent [2Electric []Hot Water [2Suppl.[]Con. Burner
ced
Air
[]Radiant
BEING LINED,,~q'o []~es - LINER SIZE & MANUFACTURER
IS
CHIMNEY
Note: All chimneys shall be sized per the BTU s being vented.
CHIMNEY TYPE []Chinmey A []Chimney B I-1Direct Vent []Other
HEAT LOSS []As Approved []Existing . I-1Not Applicable
BTU RATE []As Per Plan []Variable F1Other Value
,sc ImO
~ ~ _1
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR (~r~ C ,~f OR ~]~,,Electric Installation Verification form attached(If Replacement)
~ectrical installation of new/replacement equipment shall be done by licensed contractor
~"~ ' ~,.~k~ ~1'~1°~
3/02
FROM
:UICK[>UANSHEATING
FA~ NO.
:9203362950
Mar~.
11:50AM
P2/2
~ (we) _
Electric Installation Verification
Co~c.~/~- 5?4:<~5
(Electrical Contractor Name)
do ~,3 ,, .>/,<? :? ~ ~e ~ ~ ~ J-Vi/:
(Address) (City) (State) (Zip Code)
havebeum contracted to perform electric installation work for _[,/~
.(Name of party contracted to)
at the following address: ~/J O.~2j)/
(Address where ~/ork will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
._~ Recormecfion or new circuit for replacement Heating Plant and/or A/C Condenser,
,, Reconueefion or new circuit for replacement lltlectrie Water Heater or power vented
water heater.
Reconneetion of the SerVice Entrance Cable, Meter Box, alterations to reeeptacles
and lighting fixtures due to siding ! soffit installation. Note: New Service
Entrance Cables will require a separate pen'nit.
__ Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to anindivfdual dwelling unit (house or the
individual systernz in a duplex or condominium), including required service
tire.cai outlet&
Other
The value ofthiswork is $ ~ 0 lO ~ I 0 ~ l '
I hereby verify this work will be performed by au employee of this company and further verify
the reconnecti~stallation will be done in compliance with manufacturer and Electric code
requirement~/~ \-~
~o£::"' ' " "
v"'"(Si~natfire of Company Officer)(Print Name of officer)" (Date)
5/O2