HomeMy WebLinkAbout0092814-HVAC (furnace) 0 CITY OF OSHKOSH No 92814
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1411 POWERS ST Owner MARC J FIORELLO Create Date 02/26/2002
Contractor MONROE HEATING & COOLING LLC Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas J Oil Electric Solar Solid
System n New 1 4 Replace ❑ Other
j Forced Air j Radiant U Steam LJ NC U Vent
1 Electric 1 Hot Water Suppl. 1 Con. Burner
Chimney Type ` ) Chimney A () Chimney B • Direct Vent U Not Applicable
Heat Loss 0 As Approved • Existing 0 Not Applicable Value 0
BTU Rate ) As Per Plan U Variable • Other Value 50m
Use /Nature SFR/ Replace fumace. *EIV form from Seckar Electric.
of Work
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: VVi Date 02/26/2002
0 Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address P 0 BOX 545 OSHKOSH WI 54903 - 545 Telephone Number (920) 232 -6838
Division of Inspection Services
(Iii-0; 215 Church Avenue
P.O. Box 1130
Oshkosh, 1130
Pax # (920) 0) 236 - 50 236 -5084
w Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
1rl-�1 DATE
JOB ADDRESS y I( V C,N( ` 9 �r P
OWNER c, L f)Td(o
CONTRACTOR 11\ c.) Q_' H '}(%ham d ' ( l Ills
CIRCLE ALL APPLICABLE
USE CATEGORY Vain& DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL ( OIL ELECTRIC SOLAR SOLID
SYSTEM ; y � •, +. •LAC, OTHER
TYPE FORCED A RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CQN. BURNER
IS CHIDQiEY BEING LINED LINER SIZE Z fl 2 J S MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMER TYPE CHIMNEY A CHIMNEY B DIRECT VEN' OTHER
HEAT LOSS AS APPROVED ISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE.j'U`U
NATURE OF WORK: If) ,
60 VALUE (Including labor and materials) $ , LJ 4do
ELECTRICAL CONTRACTOR catEVA4r t
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$ 0 to
$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 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
greater.
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
�
�7 Oshkosh WI 54902-1130
OJHI(Q H Office 920 - 236 -5050
ON THE WATER Fax 920-236-5084
Electric Installation Verification
(I) (We) vEcrAr ELECTr i c Co no e_.
(Electrical Contractor Name)
S/ 20 Co () elide/ f°LL)/►^ toot-comae w/ 6q1204,
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for/ 0 OrOr ' //l./6
(Name of party contracted to)
at the following address: I (tit POcz1E...s S Ti
(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 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
The value of this work is $ 2-coo
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.
i Stc.t� DAVE 1e. stc Ale t }�N. z Z ol a
(Signatu e of Company Officer) (Print Name of Officer) (Date)