HomeMy WebLinkAbout0101120 HVAC (A/C)OSHKOSH
ON THE WATER
.lob Address 230 SCOTT AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
HOLLAUS HEATING & A/C SERVICE
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner GEORGE F WILBER
Category 501 - Residential-Air Conditioning
Electric
Replace
Steam
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
101120
04/30/2003
Other J
Vent J
Use/Nature SFR/Install air conditioner.* EIV from Hoehne Electric attached
of Work
Fees: Valuation
Issued By:
$1,500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$27.50
Date 04/30/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1535W BENTAVE OSHKOSH WI 54901 -2730 Telephone Number
(920) 235-7397
OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
230 SCOTT AVE
HOLLAUS HEATING & NC SERVICE
Gas I
[] Forced Air
bd Electric
Oil
Radiant
Hot Water
Chimney Type ~.~ Chimney A ~.~ Chimney B
Heat Loss ~ As Approved (.~ Existing
BTU Rate E~ As Per Plan ~ Variable
Owner GEORGE F WILBER
Category 501 - Residential-Air Conditioning
[] Electric 1 b~ solar
~. R _e_p?_ce ..............
LJ Steam I
LJ Suppl.
(.~ Direct vent O Not Applicable
O Not Applicable
~1 Other
~ Nc J
r J Con. Burner ]
Value
Value
No 101120
Create Date 04/30/2003
Plan
[] Solid
[] Other
Vent
Use/Nature SFR/tnstall air Conditioner.* EIV from Hoehne Electric attach'ed
of Work
Fees: Valuation
Issued By: ~
$1,500.00 Plan Approval
$0.00 Permit Fee Paid
.~ ._P~rm_ i_t_ _.V_oid e_cl.~
$27.50
Date 04/30/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
S ignatu re , .~_ ~~ 7~~
Agent/Owner
Date
Address 1535 W BENTAVE OSHKOSH WI 54901 -2730 Telephone Number
(920) 235-7397
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
OJ1---tKO/H
ON THE WATER
HVAC 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 greater.
OR
I_f you are a contractor participating in the Permit fee Account System and have adequate funds, check here
(f vou want this processed through your account ['
DATE
JOB ADDRESS
CHECK ~ ~L
USE CATEGORY
,J~Single Family F1Duplex
ElMulti-Family
IDRental [3Commercial [3Industrial
FUEL F1Gas FIElectric F1Solid SYSTEM [~e [3Replace
[3Oil FlSolar [3Other /~/C___
TYPE
[3Forced Air F1Radiant [3Steam EIA/C I-'IVent F1Electric FIHot Water F1Suppl. F1Con. Burner
IS CHIMNEY BEING LINED [3No I-lYes - LINER SIZE
Note: All chi.,wneys shall be sized per the BTU's be.ing vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[3Chimney A
I-lAs Approved
FIAs Per Plan
l-IChimney B
F1Existing
[3Variable
F1Direct Vent
[3Not Applicable
FIOther Value
[3Other '
DESCRIPTION oF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR . . :-'.: OR ' .Electric Installation Verification form attached(IrReplacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box ! 130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(We)
(Electrical Contractor Name)
(Address) (City) (State)
have been contracted to perform electric installation work for
(Name of party contracted to)
(Zip Code)
at the following address:
(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 replacement Heating
for
Plant
and/or
A/C
Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
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 the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex Or condominimm), including required service
electrical outlets. '
Other
The value of this work is $
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.
(Signature of Company Officer)
(Date)
5/02