HomeMy WebLinkAbout0100953-HVAC (A/C)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2629 TEMPLETON PL Owner TERRY L ZUEHLKE
Contractor RASMUSSEN'S HEATING & A/C INC Category 501 - Residential-Air Conditioning
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 O Chimney B ~ 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 2 1/2 TON
No
Create Date
Plan
~J Solid
Vent
100953
04/23/2003
Use/Nature SFR/Replace A/C* EIV from Slims Electric attached.
of Work
Fees: Valuation
Issued By:
$2,774.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$47.00
Date 04/23/2003
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 Inspection
P.O. Box 1130
Oshkosh, V¢'154903-1130
Phone (920) 236-5050
Fax (920)236-5084
OJl-IKO
OM THE WATER
HVAC PERMIT APPLICATION
All information af~ bold categories must bc provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can b~ brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Co~-~n¢ing work without permit(s) will r~sult in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I. f you a,re a contractor participating in the Permit fee Account System and have adequate_funds, check here
if you want this processed through..your account ~'] . ·
JOB ADDRE$S ~:~x~q
CONTRACTOR
~CK [] ALL APPLICABLE
USE CATEGORY
[~ingl¢ Family r'lDuplcx
12]Multi-Family
FIRcntal V1Commercial [3Industrial
FUEL Efts EIEl¢otrio rlSolid
[3Oil [3Solar
TYPE
I-IForced Air VIRadiant [3Steam ,~C [3Vent
IS CHIMNEY BEING LINED E~o ElYes - LINER SIZE
Note: All ehinmeys shall be sized per the BTU's being vented.
~ TYPE vIChi~ey A ~imney B
I~,AT LOSS I-lAs Approved EIExisfing
nAs Per Plan E]Varia~l¢
SYSTEM E]New E~Replace
[3Other
l"lE]ectric CIHot Water [3Suppl. EICon. Burner
& MANUFA~R
[3Dire~ V~nt ElOther
KINot Appl/~able
DgSCRnq~ON OF ALL WORK
VALUE (Including labor and ali ranterinls inaudlng light fixtures) .$
l~.?o~r .al~pl~/.oab!e ..p~o~eo~., an Eleotr/o Ins/aHafion V~/fioat/on fo .r~n, signed by the Eleetri~ Contractor, must be
auacne~ t~ not attaohed or not applioable, a SOlnnat~ Eleotr/oal Permit is requ/red.
Electric Installation Verification
(Eleotrioal Contra~r Name)
(Ad~) " (City) (St~) (Zip Code)
(Name of party contracted to)
(Addre~ where wo~ will be ped. ormal)
The nature of the work ~ o~ (.Cheek (he or Desm'l~ the Nm of W~)
~~ of~ ~ ~ ~le, M~ ~ ~~ ~ r~cl~
~ ~g ~ ~e ~ ~ / ~ffit ~on. Note: N~
l'he.valueofthiswo~kis$ /~'0. oo,