HomeMy WebLinkAbout0100415-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 1250 ARDMORE TRL
Contractor VANS HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ROBERT C OIEN
Category 502- Residential-Both
Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100415
03/26/2003
Other J
Vent J
Use/Nature SFR/Replace furnace and install new A/C. *EIV form from Concept Services Inc.
of Work
Fees: Valuation
Issued By:
$5,688.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$90.50
Date 03/26/2003
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
City e£ O~hkosh
Division of Inspection Services
P,O, Box 1130
Oshkosh, Wt 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
l,mcomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or maikd to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus thc
normal permit fee, which ever is greater.
OR
If you are a ~ontractor _~artie~patirts~,~ the P~rmit Ice Account System and have adequate _[~tnd.~, check here
if you w.~nt this processed through your account
CHECK li~ ALL APPLICABLE
USE CATEGORY
~fngl¢ Fanfily nDuplex
~Multi-Family UlRental ["lc°mme~cial nlndustrial
'~ecmc UlSolid
FUEL SYSTEM [-1New
~Oil nSolar l-IOther
TYPE
~'~reed Air E]Radiant ClSteam~(A/c ElVent DElectric UIHot Water EISuppl.l-lCon. Burner
IS CHIMNEY BEING LINED ["lNo ~s - LINER SIZE ~ ff & MANUFACTURER
Note: Ail chimneys shall be sized per the B"f~J's being vented.
CHIMNEY TYPE E]Chimney A l-lChiraney B I-IDirect Vent U. IOther
HEAT LOSS I-lAs Approved EIExisting EINot Applicable
BTU RATE I, IAs Per Plan I-IVariable EIOther Value
DZSCRIP'r'Io~ OF ALL WOI~ BEING DON~
,l~r~er~place
VALUE O.el,dlug l-hot and sill materials Including Ii,bt fixtures) $ .~j'"~, ~;~ 0.~.~_0 .
, : ~l~tricaFt~tallati~t o/ti~r~ili,ctt{~lll ~quiptnent shall &e dona by
~d Hd60:IO 000E 98 '~ON : 'ON XU3 :
~EPT SEi~ICE~ _
FRX ND.
: 920-33~-8~97
Mar. 18 ~ ~:O1PM Pi
Electric Installation Verification
~l~;~cal Co~,~tor Namo)
Th~ value of this work
'I hereby verify ~his work will I~ performed by an ~nployee of ~is company and furlhor verify
tho r,connecfion / installation will b= done in compliance with manufacturer and Electric code
(:~ignamm of Company
(Print Name of Officer}
Sd Wd60:TO 000E SE '~C~l : 'ON XUJ
: WO~J