HomeMy WebLinkAbout0100334-HVAC (furnace & a/c)�CITY OF OSHKOSH No 100334
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OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1719 CENTRAL ST Owner LARRY D/KAREN R CHAPIN Create Date 03/21/2003
Contractor VANS HEATING & A/C INC Category 500 - Residential-Heating & Ventilating Plan
Fuel ✓ Gas Oil ✓ Electric Solar Solid
System New ✓ Replace Other
✓ Forced Air Radiant Steam ✓ A/C Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent � Not Applicable
Heat Loss As Approved Existing � Not Applicable Value 0
BTU Rate As Per Plan Variable � Other Value 94m
Use/Nature SFR/ Replace furnace and install new central air. 'EIV form from Concept Services.
of Work
Fees: Valuation $6,241.00 Plan Approval
Issued By:
Permit Voided
$0.00 Permit Fee Paid $99.50
Date 03/21 /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
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City of pshkosl� M�,� `�� � ���
Division of Inspectiou Serv�ces � Q 20��
P.O. Box 113� �`'���, �'��
Oshkosh, WI 5494. -1�'�,• : ; , ���°��A
'Phone (920) 236-SO50 �`' �B �`''` . �P��l'
Fax (920) 23G-5084 � �� �°�����
H ERMIT APPL�CATION
All information s�ft�r 6old cAtegories must be provided:
Incornplete applications will not bc processcd.
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� Application(s) and fee(s} cnn be brought to Ciry i-Tall, Ro�m 2�5 or mailed to lnspection Scrvices, PO Box 1128,
Oshlcosh �l�'1 �4903-1128. C�nuneneing work without permii{s) will result in fees being doubled or $lUO.UU plu� the
normal pemut fee, �rhich evcr is b*reacer.
OR
SOB AllDRESS / �% "�'f ��� n �r��t. � �� •
O�VNE�t � r..� G —T
r.rr�Tmri � �mr►n � / .... � .- � �... -.L. � . �
CIiECK � ALL APPLICABLE
DA'I'E � �7 ��� �...w..
USE CATEUURY , . :.., , _
�in�le Family C1Uu�lex �Multi-F�unily ❑Rental ❑Commercial ❑Industrial
FUEL �Gaa �cctric OSalid SYSTEM Ol�c:w �tc;glace
lClOil ❑Sular �(:)chcr -
TYYE
�orced Air �Rfldiant t7Stearn�AiC I7Vent ❑Electric �Hat Water C1Supp1.ClCon_ Burner
I$ CHi1V�NE'Y BEING iINED ONo�Yes - LIN$R $Il�� f� & MANUTACTURER,,;,�R���''�
Note: A1I Chimncys shall be sized per the TU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B L7Direct Vent ClOther
HEAT LOSS ❑As Approvc:d ❑�xisting C1Not Appiicable ��-
l3TU ItATE ❑As Per Plan ❑Variable ❑Uther Value � � [%�t".� � ��2 �
DESCRIPTIQN F ALL WUItK BETI�TG DONE l� �'. j0 �R [ Q -I- U r v� �t r' E�
r+� 7�-•r r� o v� �� rt �� �t � q- � t� - -
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VALUE (Inciuding Iabor and all materiats including light fixtures) $�_�f ""'�
ELECTRiCAL CONTRACTOR OR �t( GlectHc lnstallation Verlticatla� farm attaehed(!f RepYacernnnt)
Electrlcnf fnsr�!lnttan ojnewii•e�l��ccti�ien! equipu�cnt slml( Ge Jone by licenaed cnnnnc�o+
�'��1Cf�� S� �'vi �� 5 Gt..� i C� �cik i Y�
�.�. � � � � �; r ��_�..r. : � ��P � � � � ���
3/03
Zd WdZS:£0 000Z bZ '^�N :'ON Xd� : W0�1�
� FROM : CONCEPT 5ERUICES
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IHK�)tH
CNLL iuF YUTfA
FAX N0. : 920-336-8697
c;ry ofosAkosh
f)iviSiu� of iroqechon Scrv;cas
21i C1turcD AvCnuc
P�} Hoz I 130
C>sAkosh Wi SA40}-1134
oR�o 9za23�>o>0
Fax 920-?36-SU8i
Mar. 18 2003 02:36PM P1
Electric Installation Ver�fcation
Y (w�� _ G D n GE'� �"� :��vi C�'.� ..� � � >
(Electrical Contractor Name)
�1�3� ��
(Address)
(City)
��
�s
(State) (Zip Code)
have been contracted to perfozzn electric installation work for_ f/'/��nS ��'�;,�� �. [��.i��
(Name of party contracted to) �
at the following address: 1� /� CC�tI-j-2�}L. ��,
(Address where work wi11 be pezfoimed)
The nature af the work consisis of (Check One or Describe the Natwe af Wozk)
� Recon»ection or new circuit �'ox replacement Heating Plant ar�d/or A/C Cond�nser.
� Recottnect�on or new circuit for xeplacement Electric Water Heater or power ventet�
water heater.
Reconxtection of the Service Entrance Cai�le, Meter Bax, alterations to recepta�les
and Iighting fixtures due to siding / saffit insta[lation. Note: New Senrice
�ntrance Cables will requixe a segara�e permit. •�
Reconnection or new c�rcuit for the replac�ment af other pez�manently wxred
appliances ! fixtures.
New circuit for the addition of AIC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), inctuding required service
electrical outlets.
,,,_ Qther
The value of this work is $ �d, a� ,
I hereby verify Ehis work will be performed by an employee of this company and further veriFy
the r�cannectio�nstallatiQn will be dane in campliance with manufaciu�er and Electric code
..._..-��, ��'.�.v�' ���a�►� -- ��' � 03
of Coxnpany Officer) �{Print Name of Officer) (Date) `
5l02