HomeMy WebLinkAbout0089845-HVAC (furnace) (9 CITY OF OSHKOSH No 89845
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1828 MENOMINEE DR Owner JOHN E BERMINGHAM Create Date 10/01/2001
Contractor RASMUSSEN'S HEATING & A/C INC Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓1 Gas n Oil Electric 1 Solar 1 1 Solid
System n New 0 Replace 0 Other
u Forced Air J Radiant J Steam J NC J Vent
1 Electric Hot Water Suppl. Con. Burner
Chimney Type K) Chimney A • Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss n As Approved • Existing 0 Not Applicable Value
BTU Rate C As Per Plan n Variable 0 Other Value 80,000
Use /Nature SFR/Replace furnace* EIV from Hoehne Electric attached
of Work
Fees: Valuation $3,430.00 Plan Approval $0.00 Permit Fee Paid $57.50
Issued By: /"`------ Date 10/01/2001
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 5154 DAVID DR OSHKOSH WI 54904 -0 Telephone Number 920 - 235 -6569
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. 7,
Division of Inspection Services
-21S Church Avenue
P.O. Box 1130
Oshkosh. WI 54903 -1130
Fax $ (920) 236 -5084
�rt w ` Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE q -a‘ -0 i
JOB ADDRESS / /'mown :ne.e. tr.
O W N E R Sohi■ i?i r rr►;
CONTRACTOR RoArh 0 SScr 's 141/A (-
CIRCLE ALL APPLICABLE
USE CATEGORY NIItGLE FAMILY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL (g51 OIL ELECTRIC SOLAR SOLID
SYSTEM NEW (REP) OTHER
TYPE FORS RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED 1• LINER SIZE MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A �� DIRECT VENT OTHER
HEAT LOSS AS APPROVED EX NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE 963, 000
NATURE OF WORK:
VALUE (Including labor and materials) $ 14 50
ELECTRICAL CONTRACTOR M cH, n A t 4 •
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 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_ _ ...._......x........$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
Osb task
m�orarlowt sa•ices
215 Cio& Metre _
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atone tom Fst 9211226-5118 Office
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Electric Installation Verification
(I) (We) N OE hne. Electrtc
(Electrical Contractor Name) p
6 2, E'. C P 4 :o army* w I sy i 3
(Address) (City) (State) (gyp Code)
have been contracted to perform electric installation work for R4s tau sscn t ntr 1 VAC_ ,
(Name of party
•
at the following address: 18a?8 M e»ow► •n ec. 13 r
(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 replac en art Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Eric Water Heater.
Reconnection of the Service Entrance Cable, Meter Boa, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
Cables will require a separate pe it. wined / fixtures. Reconnection or new circuit for other p�nanendy
Other
The value of this work is $ J 6 . °O -_
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.
-‘,Artfa(----/e---4/4t, / A. li . ..s dt_tiik I -a6-0i
(Signature of Company Officer) (Print Name of Officer) • (Date)