HomeMy WebLinkAbout0104095 HOSHKOSH
ON THE WATER
.lob Address 735 MONROE ST
Contractor AMERICAN HEATING & A C CO
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner SUSAN J ZELMER
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO ChimneyA ~ Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
104095
09/10/2003
Other
Vent J
75m & 24m A/C
Use/Nature SFR/Replace 75m btu furnace and add 2 ton central A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$4,100.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$66.50
Date 09/10/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number
(920) 235-8090
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
.City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
SEp 10 2ooj ~
C O£P~ler,~r-
O/HKO/H
OMMUN,~,, ~NT OF ~ ~ ~
HVAC PER~IT aPPL C fI6
All infomation 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
l£ you are a contractor participating in the Permit fee Account System and have adequate ['unds, check here
if you want this processed throu~/_L.Eot~:_a~_c_rLltnt [-~
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
~ingle Family mDuplex V1Multi-Family
UtRentat [:]Commercial [llndustriat
FUEL ,,l~Gas [3Electric [lSolid SYSTEM [3New
'J[~eplace
I-IOiI [3Solar mOther
TYPE
~%rced Air [3Radiant [3Steam ~X[:X/C [3Vent [2]Electric [31tot Water Bumer
[3Suppl.[3Con.
BEING LINED [3No [~es - LINER SIZE '~ ~ & MANUFACTURER
IS
CHIMNEY
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ~.Chimney A F1Chimney B [lDirect Vent [3Other
HEAT LOSS [lAs Approved ~xisting [3Not Applicable
BTU RATE I-lAs Per Plan [lVariable tlEIOther Value ,~, ¢~,0 ~_
DESCRIPTIONOF ALL WORKBEINGDONE ~d~ 7...~,¢:~ ~
VALUE (Including labor and all materials including light fixtures) $ ~'/r/t~ ~
ELECTRICAL CONTRACTOR O.~R ~lectri¢ Installation Verification form attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
~/o2
Electric Installation Verification
(Electrical ~n~actor
(Address) (Ci~) (State) (Zip C~e)
have ~en connoted to perfo~ elect~c imtallation work for ~ta~ /~ ~,
~ of p~y con~t~ to)
a ~e following ad~s: ~ff~ ~o~
(Ad'ess where work MIl bc peffom~)
The nature of the work consists of: (Check One or Describe thc Nature of Work)
~>~ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circu/t for replacement Electric Water Heater or power w-nted
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures duc to siding / soffit installation. Note: New Serv/ce
Entrance Cables will require a separate permit.
__ Reconnection or n~w circuit for the replacement of other permanently w/red
appliances / fixtures.
~ New circuit for the addition of 3dC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), 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.
(Print Name of Officer) (Date)
5/02