HomeMy WebLinkAbout0089493-HVAC (furnace & a/c) CITY OF OSHKOSH No 89493
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1712 WHITE SWAN DR Owner DAPHNE C RIEDI Create Date 09/19/2001
Contractor MONROE HEATING COOLING LLC Category 502 Residential -Both Plan
Fuel 111 Gas 1 Oil Electric 1 Solar Solid
System New 1 121 Replace 1 0 Other
u Forced Air U Radiant J Steam u NC U Vent
1 Electric 1 Hot Water Suppl. U Con. Burner
Chimney Type Chimney A Chimney B Direct Vent 0 Not Applicable
Heat Loss j As Approved Existing 0 Not Applicable Value
BTU Rate As Per Plan Variable 0 Other Value
Use /Nature SFR/ Replace furnace and install NC. *EIV form from Seckar Electric.
of Work
Fees: Valuation $5,000.00 Plan Approval $0.00 Permit Fee Paid $80.00
Issued By: 1.41,41 Date 09/20/2001
D Permit Voided 1
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 2527 BOWEN STREET OSHKOSH WI 54901 -2021 Telephone Number (920) 232 -6838
4-03-1995 9 53PM FROM P. 1
e Division of Inspection Services
215 Church Avenue FD
7
'J)�� Pa P.O. Box i130 tt
7�° r hko�. 54903-1130 e
Pax p (520! O) 238 -5081
Phone (910) 236 -50ea
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HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed_
DATE
JOB ADDRESS f l 1 Z eh (k .Sc..i o n !I've
OWNER 0 .1)`re f2 ;PI
CONTRACTOR Cl1 o n f o 2, ti+ n 5'I( 001 c r s
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL G OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLACE OTHER
TYPE FORCED AIR/ RADIANT STEAM A /CV VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BRING LINED LINER SIZE 35' MANUFACTURER
Note: All chimneys shall be sized per the STU's being vented. I CHZ1Q><EY TYPE CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED{ EXISTINl7' NOT APPLICABLE
BTU RATR AS PER PLAN VARIABLEY OTHER VALUE
NATURE OP WOREs
R 4i-e_ rrnoc..e. a.ult tr Sj4!( C-iAC. U
VALUE (Including labor and materials) i 00 U
ELEC RIC„AL CONTRACT. C. K" E \c
Electrical installation o new /replacement equipment Shall be done by Licensed
contractors.
Valuation Fees
$o to $1,000 00 $20.00
$1,000.01 to $10,000 00 $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000 00 .$305.00 plus $0.50
per $100.00 valuation or part thereof
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
FROM SECKAR ELECTRIC FAX NO. 9202313950 Sep. 17 2001 0B:2BPM P1
City of o Ci f nsh
Inspection
21 1 Chu c h A v enue Services
2 S Church Avenue
DO Box 1 130
Oshkosh WI 54902-100
OJF I<QJH oft. 920.236-5050
ON THE WATER Fax 920. 2365084
r
Electric Installation Verification rrLL
(1) (We) C 0, C1 (C CO /N
(Electrical Contractor Name)
SCao CO6rTla f LUJ 1 fi jeD R)Bo"0e CO/kE
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for Awizo.E- H Elir /Ai G
(Name of party contracted to)
at the following address: 1 7 [2._ in= 1S 61/71) b-1
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser,
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances fixtures.
Other
The value of this work is Co
I hereby 'verify this work will be performed by an employee of this company and further verify the
reconnection installation will be done in compliance with manufacturer and Electric code
requirements.
0 E (-I
Der E )e K /7 ZoE)/
(Signature of ompany Officer) (Print Name of Officer) (Date)