HomeMy WebLinkAbout0100954-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 2132 N MAIN ST
Contractor VANS HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner CHRISTOPHER B VALDEZ/J M SCHROEDf
Category 502- Residential-Both
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
100954
04/23/2003
Other J
Vent J
Use/Nature SFR/Replace furnace, install new air conditioning & chimney liner.* EIV from Concept Services attached.
of Work
Fees: Valuation
Issued By:
$4,214.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$69.50
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 525 BUTLER ST DEPERE WI 54115 -5426 Telephone Number
(920) 336-2816
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
Ail information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKOfH
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oablco~ WI 54903=1128, Commencing work wifl!out permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, whioh ever is greater.
OR
[[i VOu are. a contractor particinat~ng in the P~rm~t fee Account ,~v.ytem and. kava od~q.u, ate [bnd~, che~k here
(f_vou wa~t. this processed through Four t~ccount N
DAr~ ~/-/~-V 3
~oB ~t,~ss ~ ! 30- ~, ~; ~ ...~-6.
owsze CL/~ r; ~ V~/,,/~ ~__.~ _
CHECK I~ ALL APPLICABLE
~s~c~,~0% -,~ ~ ,~ ~: ~ ,~.: ~ :~ ~,~, ~, .........
~i~;irtgle Family r'lDupl~x ~Multi. Famil~ r=lRental . r'lComm~cial UIIndu~trial
FUEL ~s I-IEl~ctric ClSolid SYSTEM ClNew ~llteplace
clOil FISolar ClOthe'
TYPE
~6~roed Air C]Radiant I-]Steam ~ E]Vent ClElectric r'lHot Water
r'lsuppl.
IS CHIMNEY BEING LINED ~No~s - LINER SIZE ~ t ! & MANUFACTURER
Note: All chitrmcya shall lac siz~ per the BTU's being vented.
CHIMNEY TYPE nChinmey A C]Chimney B ~Direct Vent rlOthcf
I-IEAT LOSS r'iAs Approved i-lExisting l'lNot Applicable
BTU RATE r'lAs Per Plan I-IVariable CIOther Value
_/ - /
l-ICon. Burner
ELECTRICAL CONTRACTOR ('-',o ~ e ,e ~ ~-' ~e t~.,'¢, e: _~
E] For applicable projects, an Electric Inst~llation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not aPPlicabh:, a separate Electrical Permit i$ tequired'
FROM
Mar. 18 20EL~ O~:O1PM Pi
Electric Instaflatlon Verification
O!l~:tric. al ~~ N~o)
(Ad.ess) (CiW) (State) ~ip C~e)
(/d~n wh~ wo~ will be pO=~) '
The nalure oflhe work consists o15 (Cheek On~ or Ii, scribe the Natur~ of Work)
R~onnection or new oircuit for rop~ Heating Plant and/or AIC ~ondense~.
Reconn~ti0rl or new circuit for r~la~etneat ~fic Water H~ater or power wmted
warm- hoater.
Reconn~tion of th~ Service Entrsnce Cable, Meter Box, alterations to
and light~g flxtur~ due to aiding I soffit installation. Note: New Service
Eniza~o~ Cabl~s will .l~, ,uir~ a separate permit. '
R~cellneofion or nsw ci~mt for the replaomnmlt of olhm' pmmanenfly
appliances / fixtm'es.
N~w circuit ~0r the a&lilion of A/C to au indivitm:l d~elI~g u~tt Omus~ or
individual systems in a duple~ or condomiaium), including required sarvice
electric, al outleta,
Other
Thc value of this work is $ ~C)O.O0 ,.
i hereby verify this wol~k will be pe, rfor~ed by an employee of Ibis company ~ furlh~r verify
the reconnection / installation will be done in complianoo with mauuf-actteer and HI .ectfic co~o
requirements. ~ '
(:~tgnature o: Company om~') (lnint N~m v£Orlloo0
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