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HomeMy WebLinkAbout0100556-HVAC (furnace)(~ CITY OF OSHKOSH OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1660 OHIO ST Owner NATHAN hi PAULOS Contractor WESLEY HEATING & COOLING INC Category 500 - Residential-Heating & Ventilating Fuel ~J Gas J ~J Oil b~ Electric ~J Solar System ~J New ~ ~J Replace ~ ~J Other ~J Forced Air I ~J Radiant L~ Steam ~J A/C ~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I Heat Loss I~ As Approved O Existing ~ Not Applicable I Value BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 50m btu No Create Date Plan ~J Solid Vent 100556 04/01/2003 Use/Nature SFR/Install furnace. *EIV form from Solar Electric. of Work Fees: Valuation Issued By: $2,600.00 Plan Approval $0.00 Permit Fee Paid Permit Voided $44.00 Date 04/01/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1736 SAL STREET GREEN BAY WI 54302 -0 Telephone Number (920) 468-6951/235-6 ,City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 O/HKO/H ON THF WATER HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. · Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $1.00.00 plus the normal permit fee, which ever is greaten OR If you are a contractor participating in the Permit fee Account System and have adequate funds, check here if you want this processed through Four account ~ JOB ADDRESS OWNER Cl:W~CK [] ALL APPLICABLE Sin CATEGORY gle Family FUEL V/Oil ElDuplex FIMulti-Family VIRental DATE V1Electric FISolid SYSTEM VtSolar T E ~oForced Air V1Radiant V1Steam E]A/C F1Vent E1Electric VIHot Water FISuppl.viCon. Bumer IS CHIMNEY BEING LINED VINo I~es - LINER SIZE ~/// & MANUFACTURER Note: Ail chimneys shall be sized per the BTU's being vented. CHIMNEY TYPE [-IChimney A V1Chimney B ~Direct Vent F1Other HEAT LOSS [2]As Approved I~(Existing V1Not Applicable BTU RATE VIAs Per Plan V1Variable VIOther Value 5"O/ ~ DESCRIPTION OF ALL WORK BEING DONE VALUE (Including labor and all materials including light fixtures) $ a~, ~ 00 ' 0 ~ ELECTRICAL CONTRACTOR F.4,.'~I ~ OR [] Electric Installation Verification form attached(If Replacement) Electrical installation of new/replacement equipment shall be done by licensed contractors. 3/02 03/25/03 11:03 F~ 920 236 7725 Solar Electric Electric Installation Verification .2 The mmre of the wo~ ~ o~ (.Check One or Descffoe the Nemrc of Wozk) ..... Kcconnmion ofthe Senticc Eutnu~ Cable. Metro Box, alterations mcll/~h6n, fixtm.~ ~cm ~lia~/~tFatb~tall~a~. Note: N~~ ~~/~. ol~c~ ~. The ~ of this work i~ $. 7Y. ~ o I hm'eby vcri~y lhis work will be performed by fn employee ofl~is company Lud ~ verify the reconnec~ion / instalhtion vail be done in complisnce witl3 ~r end Electric amle requirements.