HomeMy WebLinkAbout0086255-HVAC (a/c) (9 CITY OF OSHKOSH No 86255
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 931 MONROE ST Owner JAMES & JANICE SCHWERTFEGER Create Date 04/25/2001
Contractor RASMUSSEN'S HEATING & A/C INC Category 501 - Residential -Air Conditioning Plan
Fuel 11 Gas 1 Oil Electric Solar I 1 Solid
System 0 New 1 ❑ Replace
7 Other
u Forced Air u Radiant j Steam ✓] NC u Vent
1 Electric Hot Water
l Suppl. Con. Burner
Chimney Type ) Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss ) As Approved • Existing 0 Not Applicable Value
BTU Rate ( ) As Per Plan () Variable • Other Value 30,000
Use /Nature SFR / INSTALL NEW 2 -1/2 TON A/C
of Work (No electric permit required- received installation verification signed by Hoehne Electric)
Fees: Valuation $2,600.00 Plan Approval $0.00 Permit Fee Paid $44.00
Issued By: Date 05/23/2001
❑ 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
Rpr 23 01 06 :56p Scott Noe 920 -232 -0455 p.2
(S) Division of Inspection Services
215 church Avenue
P.O. Box 1130
OA -KWH Oshkosh, 54903 1130
oft mg...0. P E920) WI -
235 -5084
Phone (920) 236 -5048
HVAC PERMIT APPLICATION - _
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 44 -a L4 _ G 1
JOB ADDRESS 93 t Monroe:.
OWNER 3ean;cc. SC.‘""-ler4r4c -Scr
CONTRACTOR ' , o.gw►uSScan tL 14 VAC- --
CIRCLE ALL APPLICABLE
USE CATEGORY CINGLE FAMILY DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLACE OTHER
TYPE FORCED AIR RADIANT STEAM T3' VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED MO LINER SIZE MANUFACTURER
Mote: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE t..Vic CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED CEXISTINi) NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE of lia Too expo
NATURE OF WORK:
AAA : nt, A:r Gorat +tw•ar
VALUE (Including labor and materials) $ a, ,c 00
ELECTRICAL CONTRACTOR 1'1 dG b1ri . kletA-1^ i C.
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_ ._...._._.___._ ... ti - _._ .... .__, __-____-$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
greater.
flpr 23 01 06:56p Scott Noe 920 - 232 -0455 p,3
Clay of Os*osh - -
21.5 Croat Mane
!PO S.,' Mg
asritushWI S49024110
Office 920236-5059
OI fl W -R fax 940.2345024
Electric Installation Verification
(1) (We) HOE hoe. tc.
(Electrical Contractor Name)
62 E. ovrtike avnro w l 5
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for R4Swsu SSer► H ,
(Name of party contracted to)
at the following address: 4 1 . 3% Monroe.. =
(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 $ 1 50 . 00
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- - _-
_ - j olt{ -at
(Signature of Company Officer) (Print ame of Officer) • (Date)