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Home My WebLink About0100660 HOSHKOSH ON THE WATER .lob Address 435 OLSON AVE Contractor Fuel ~J Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ADONIS HEATING AND COOLING Oil Forced Air I ~J Radiant Electric I ~J Hot Water Owner LEO M/MURIEL M METZLER TRUST Category 500- Residential-Heating & Ventilating L~ 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 100660 04/07/2003 Other J Vent J Use/Nature SFR/Replace furnace and add a humidifier. *EIV form from Seckar Electric. of Work Fees: Valuation Issued By: $2,496.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $42.50 Date 04/07/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address W2707 County Rd H Pine River WI 54965 -0 Telephone Number 685-0458 CITY OF OSHKOSH No 100660 HVAC PERMIT -APPLICATION AND RECORD OSHKOSH ON THE WATER Job Address Contractor Fuel System 435 OLSON AVE ADONIS HEATING AND COOLING Owner LEO M/MURIEL M METZLER TRUST Category 500 - Residential-Heating & Ventilating Create Date 04/07/2003 Plan [] Gas 1 [] Oil 1 ~]-Electric 1 [] Solar 1 [] Solid [] New J [] Replace I [] Other ~_J Forced Air I ~ Radiant J [~ Steam J LJ NC [] Electdc ] [~t Water 1 [] Suppl. ] [] Con. Burner Chimney Type ~ Chimney A ~ Chimney B ~1 Direct Vent ~ Not Appli~ble Heat Loss ~ As Approved ~ Existing ~ Not Appli~ble ~ Value BTU Rate ~ As Per Plan ~ Variable ~ Other ~ Value L-J Vent Use/Nature SFP,/Replace furnace and add a humidifier. *EIV form from Seckar Electric. of Work FeeS: Valuation $2,496.00 Plan Approval $0.00 Permit Fee Paid $42.50 Issued By: ~(~.J~ Date 04/07/2003 [] Permit Voided I In the pedorma, nce ork, I Signature ~ //-~--f~// ~.~~ Date ~//--7 I / /(, fAgent]Owner Address W2707 Counbj Rd H Pine River WI 54965 - 0 Telephone Number 685-0458 City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236~5050 Fax (920) 236-5084 HVAC PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. O/HKO/H ON THE WATER · 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 $100.00 plus the normal permit fee, which ever is greater. 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 your account [~ JOB ADDRESS q' ~ ~ (~)d ¢ t~.-) /f~ ~..'/ CONTRACTOR DATE CHECK [] ALL APPLICABLE USE CATEGORY tJ~Single Family FUEL ~Oasil I-IDuplex ElMulti-Family F1Rental F1Commercial IZllndustrial I-1Electric F'iSolid SYSTEM [:lNew el~l~place [] Solar []Other TYPE ~orced Air IZIRadiant •Steam F1A/C IZl~ter •Suppl. IS CHIMNEY BEING LINED ~No []Yes - L~ SIZE _~A~J~FtYFAC~R ii.Direct Vent F1Not Applicable []Other Value •Other Note: All chimneys shall be sized per the BTU's being vented. []Chimney A I-lAs Approved []As Per Plan []Chimney B [2Existing []Variable []Con. Burner CHIMNEY TYPE HEAT LOSS BTU RATE DESCRIPTION OF ALL WORK BEING DONE /~l/fLt~(-~ /cU~Y~c~ ~E VALUE (Including labor and all materials including light fixtures) $ ~ q ~,- ELECTRICAL CONTRACTOR ,.~'LC P: ~ {~L~C'7~tt" dO riO( [] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be attached. If not attached or not applicable, a separate Electrical Permit is required. 9/02 Electric Installation Verification (Etectrical Conwactor Name) (Address) (Ci~) (State) (Zi~ Code) ~ame of p~ con~ac~cd ' ' (Ad~ss where work ~]1 ~ pV~O~} The n~rare of the work Consists of: (Caeck One or Describe the Nature of Work) R.e~or~e¢~on or new cbcuit for replacement Heating Pl~,.t ami;or A/C Condenser. Re.~onnee~ion or new eLrcuit for replacement Electric Wa+.e: Heater or power vented water he~cr. Recormcction of thc Service ~ntranc¢ Cable, Meter Box, alterations to receplactes md lighting fixtures due to siding t aoffit installation. Note: New Service ]gmrance Cables will r~quire a separate pem,.it. it. ecora~ection or new circuit for the replacement of other permanently wired appliances / fixtures. New ¢irouit for the addition of A/C to an indi},iduaI dwelling anit (house or the individual systems in a duplex or condomimum), including required service eleotric~ outlets. O~er The value o£t~As work is $_ l Z..~- 0 o I heroby verify, this work will be performed by an ¢xnployee of this company and fur:her verify t~ recot~.aoction / installation ~411 be done in compliance wi-a manufacture," and Electric code r~u/rcmcnts, (Print Namo of Officer) (Date)