HomeMy WebLinkAbout0083736-HVAC (furnace) 0 CITY OF OSHKOSH N 83736
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1820 WINCHESTER AVE Owner RICHARD D CONNERS Create Date 12/04/2000
Contractor RASMUSSEN'S HEATING NC INC Category 500 Residential- Heating Ventilating Plan
Fuel Gas 011 Electric Solar Solid
System New Replace Other
Forced Air Radiant Steam A/C 1 Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B O Direct Vent O Not Applicable
Heat Loss As Approved Existing O Not Applicable Value
BTU Rate As Per Plan 0 Variable Other Value 80,000
Use /Nature SFR 1 REPLACE FURNACE
of Work (No electric permit required received installation verification signed by Hoehne Electric)
Fees: Valuation $3,192.00 Plan Approval $0.00 Permit Fee Paid $53.00
Issued By: 3K-Y--)3 Date 01/18/2001
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1915 KNAPP STREET OSHKOSH WI 54902 -6612 Telephone Number (920) 235 -6569
Division C of tier Services
2
215 Church Avenue
P.O. Box 1130
21(OH Oshkosh, WI 5 -1130
s Fax S (920) 2.36 5084
Phone (920) 246 -5048
#SAC .-PERMIT APPLI-CATION
All fields /information after bold categories must be provided.
.Incomplete applications-will not be,processed-
DATE 1‘ t \w
•)B ADDRESS i g l) Lij% trek e VI -eft_
1 1WNER 0. N'1) .&K- V
'..'ONTRACTOR 2/�-S 'n-,L A.. s s 6 n k-- u rIs C. k re--
r'IRCLE ALL APPLICABLE
f.'SE CATEGORY SINGLE FAMI DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
-FUEL .L OIL ELECTRIC SOLAR SOLID
]:STEM NEW 4iiiii) OTHER
'.`YFE
6-1E121-14) RADIANT STEAM A/C VENT
ELECTRIC HOT'WATER SUPPL. CON. BURNER
"S CHIMNEY BEING LINED LINER SIZE MANUFACTURER
Pete: All chimneys shall be sized per the BTU's being vented.
f'HIMNEY TYPE CHIMNEY A €;;;;;Y DIRECT VENT OTHER
TEAT LOSS AS AJ ?PROVED EXISTING NOT APPLICABLE
ETU RATE AS PER PLAN VARIABLE OTHER VALUE
)ATURE OF WORK:
'ALUE (Including labs -r and materials) l a•
l.,LECTRICAL CONTRACTOR i7
f.lectrical installation of new /replacement equipment shall be done by licensed
:.untractors.
''luation Fees
t o $1, 0 0 0.0 0 w.... $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
1.0, 000.01 to $25,000.00 $155.00 for first
$10;000.00 plus $1.00 per $100.00 valuation or part thereof
ever $25,000 00 $305.00 plus $0.50
per $100.0 or part thereof
i 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.
01 ZV9E 5EZ 0Z6 NI OVAH S .N3SMWSVd WO? 1 WdV t V 9661 t -S
Ciy of oshkos
Division of los•tion JeNNC9S
213 Church Assmm
Po Box 1130
l Oshkosh W1 5.+901.1130
(ill fH office 920 2X•5030
C Tr.E WATER Fax 020-236,f0111
Electric Installation Verification
(1 (W ,+4C. r 7e. SO-
(Electrical Contractor Name)
n14.. pa sr e/v3
(A 4 (City) (State) (Zip Code)
have been contracted to perform electric installation work for l "‹Pt 'YV U -f-r' C w A 1.4,t/dc.
(Name of party contracted to)
at the following address: W C k
(Address where work will. be- performed)
The nature of the work consists of Describe.the Nature -of Work)
W rL E vt- tse1 c
Reconnectian 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
iig ftitaires.due to siding soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for. other permanently wiredappliances fixtures.
Other
The value of this work is
.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.
(Signature of Company Officer) Print Name of Officer
(Si 1?� C P
11 d ZV9E SEZ 0Z6 NI OVAH S N3SSf iSV2t 1 J Wdv t V 966-L-5