HomeMy WebLinkAbout0100745-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 1718 NORTHPOINT ST
Contractor RASMUSSEN'S HEATING & A/C INC
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner DAVID S WIATROWSKI
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type ]~ ChimneyA O Chimney B
Heat Loss ]~ As Approved O Existing
BTU Rate ]~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100745
04/10/2003
Other J
Vent J
60m
Use/Nature SFR/Replacement furnace & A/C. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$5,257.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$84.50
Date 04/10/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number
920-235-6569
City of Oshkosh
Division of Inspect/on Sendces
P.O. Box ll30
Oshkosh, WI 54903-1130
Phone (920) 2365050
Fax (~0) 236-50~4
HYAC 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 $100.00 plus the
normal permit fee, which ever is gre, at~r.
OR
I_f ¥ou are a c~ntractor participating in the Permit fee Account System and.have adequate_funds, check her~
ifFou want this Processed through your account.
JOBADDRESS / 7//~ /~0r'erl~o~in~-
CONTRACTOR
CHECK I~ ALL APPLICABLE
USE CATEGORY
181Single Family FIDuplox
l-lMulfi-Family
EIRental
ElCommercial
Fllndustrial
FUEL ~ I'lElectric r'lSolid SYSTEM I:lNew ~'Replace
EIOil CISolar ClOther
TYPE
I~ForcedAir r'lRadiant ElSteam ~A/C ElVent
IS CHIMNEY BRING I. _!NI~_ ~No l-lyes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE r-lChimney A ~___.Ch!~ B IZDh~t Vent
HEAT LOSS 12As Approved I~_.xisting l~Not Applioable
BTU RATE [3As Per Plan [2Variable ~.Other Value
DESCRIPTION OF ALL WORK BEING DONE ,
FIElectric l-lHot Water FISUpPl.
& MANUFA~
V1Con. Bm-ncr
VALUE (Ineluding labor and all materials ineluding fight fixtures) $ ._~:5~ 7 ',,~ .~,:~. r. z~:~
.a~FcO,r_ _a,pp~cabl. e ~p~roj,e~, an E. le~.o ~..~fion Vcaificafion form,, signed by the Electrical Contractor, must be
cnca. r~ not auacnca or not applicable, a separate Eleetrioal Permit is requ/rcd.
Electric InmHation Verification
I 0Vo),,
a600 o,,.k,.,,,,.l c..,. ' O.,},l,~h . ~ ~ .
(Addrmm) ' (City) (State) (Zip Cods)
of Party contrao~ to)
(Address wh~ wo~WiU b*~
The nature of~ work consists o~ (.Check One or Desto'bo the Namm of Wo~)
Reommeo~m or aew c~cu~t ~or replacement Eleolxio Water H~ ~ ~ v~
,, ~~~~~~ofo~~~
Th, ya~u, of this wo~ is S.. ~ 5.0. ~