HomeMy WebLinkAbout0091938-HVAC (furnace) I9 CITY OF OSHKOSH No 91938
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1130 WINDSOR ST Owner MARY J PIOTTER Create Date 12/12/2001
Contractor WESLEY HEATING COOLING INC Category 500 Residential- Heating Ventilating Plan
Fuel I✓! Gas 1 Oil 1 Electric Solar 1 Solid
System New I n Replace 1 Other_
u Forced Air u Radiant u Steam r A/C J Vent
1 Electric 1 j Hot Water 1 Suppl. 1 1 Con. Burner
Chimney Type L() Chimney A Q Chimney B Direct Vent Q Not Applicable
Heat Loss Q As Approved Existing Q Not Applicable Value
BTU Rate Q As Per Plan 0 Variable Q Other
Value 50m BTU
Use /Nature SFR/ Fumace replacement. *EIV form from J Thomas Electric sent in on 12- 12 -01.
of Work
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $35.00
Issued By: 101'1 Date 12/21/2001
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1736 SAL STREET GREEN BAY WI 54302 0 Telephone Number (920) 468 6951/235 4
12 -14 -2001 10 -58AM FROM WESLEY_HEATING 4142357550 P.2
Division of Inspection Services
21$. Church Avenue
P.O. sox 110
OshkOsh, fWI 54903-1110
Fax p (920) 236 -5484
,..g.03 Phone `4201 236-SO49
HVAC PERJIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed_ f
DATE (2 f
.708 ADDRESS 1 WI J o/ sr r
OWNER \./01 77+0/1
CONTRACTOR W 64 t Y 6 d Gl Al b
CIRCLE ALL APPLICABLE
USE CATEGORY 66;;;;;41112 DUPLEX MULTI-FAMILY COMMERCIAL INDUSTRIAL
FUEL <gip OIL ��ELECTRIC SOLAR SOLID
SYSTEM NEW R F+p LAeE OTHER
C
TYPE FORCED AF' RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED Y LINER SIZE P MANUFACTURER
Note: All chimneys shall be sired per the BTU's being vented.
CHIMY TYPE CHIMNEY A CHIMNEY 8 IRECT VENT) OTHER
HEAT LOSS AS APPROVED X STII3G NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUR Sir
NATURE OF WORK:
72,094.4a goeklkel wind Ive44016., dirt P $ogo I/3 ripe, t14-C, Y o 'f T T n} CVt L—
cxtz y
VALUE (Including labor and materials) R000-00
ELECTRICAL CONTRACTOR
•l d 1 11 Tliofi id 15 4- L' 1.s'. E+G eemiti 1 4 Wii.G tI//2ki fhroz.
Electrical installation of newlreplacement equipment shall be done by licensed
contractors.
Valuation Fe 01:
$o to $1,000.00- W_...,..-.. ..x -.__._..$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__._._.-- —.....------$1S5.00 ...................$155.00 for first
$10,000.00 plus $1.00 per $100,00 valuation or part thereof
O ver $25,000 .00,....__....._.......__._.._, plus $0.50
per S100.O0 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.
I\f
City of Oshkosh i
Division of Inspection Services D E C I w
215 Church Avenue
PO Box 1130
Oshkosh WI 54903 -1130 DEPARTMENT F O:
O f I Office 920 236 -5050 COMMUNITY DEVELOP
1 E N
ON THE WATER Fax 920 236 -5084 R
/93
f/vI
Electric Installation Verification
I (We) 0 f� (90pu-5 ^f //Imps t L Gi /C
(print homeowner(s) name)
the homeowner(s) of /x.30 /,c) D 501? Si 05 ifir dS17 0?d 3
(address where work is to be performed)
accept the responsibility for performing the electrical work as stated below for the property listed
above.
The nature of the work consists of: (Check One or Describe the Nature of Work)
x 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
1J Is Co4)tcT Pui3Oee A./Pt iPt 66' &t T
,dew >s ht)57,3g,
The value of this work is r
I hereby verify this work will be performed by me and further verify the reconnection
installation will be done in compliance with manufacturer and Electric code requirements.
H eowner(s) Signature (Date)