HomeMy WebLinkAbout0104091-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 2217 DOTY ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
RASMUSSEN'S HEATING & A/C INC
Oil
Owner BRUCE A/THERESA THOMAS
Category 502- Residential-Both
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO 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
No
Create Date
Plan
L~ Solid
104091
09/10/2003
Other
Vent J
60m btu
Use/Nature SFR/Replace furnace & A/C. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$4,660.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$75.50
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 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number
920-235-6569
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.
P.O. lk~ lltO
~ (92O)
~ (~0) ~,-.~
HVAC PERMIT APPLICATION 5'EP 0 9 iO0~'
iacompa~te applications will not 1~ pro~i~Ua,~-~ ,.;-~, :L- vr
., ~ ~ u~VELOPMENT
· A~fi~s) ~ ~s) ~ ~ ~ ~ ~ ~ ~ 2~ ~ ~ ~ ~ ~ ~ ~ 1128,
OR
If you are a contractor ~artici~atin~ tn the Permit fee ~ceount ~vstem and have adeoaate funds, c~eck here
if you want this ~roce~ed tkro~2~ ~o~r a~cou~t .~
C-- s:CK [~ AT.I, APPLICAdlL]~
USE CATEGORY
~ingle Family KIDuplox
El.Multi-Family [3Rontal
~Commercial
ElIudushial
FURL ~Gas EIElectric r'lsolid SYSTEM EINcw l~.eplace
EIOil ElSolar ElOther
~Pol~lAir [~V~adiant OSteam ~-/C ~Ven, Cl~le~:zio [i]HotWater OSuppL
I~C'ltlMNEYBRINGLINRD[Nlqo~es .LINi~SiZE, ~' &MANUFAcrORER
~ ~/1'~. ~A ~.:,---~yB 13D/r~t v~t OOam.
EICon. Bura~r
Electric Installation Verification
O~e~zical Contractor
(City) (s~e) (zip
~e ofp~ ~n~ ~)
~ ~ ~ ~ p~o~d)
havo b~m conttae~ ~o p~onn ~lectrio imtallation work for
at the followin~ address:
The nature of~hework consists oP.. ( .Ch~k 0n= orDa~n'lm~heNatm~ of W~)
Recolmecfion re'new c/rca/t for re~lacemmt l~lec/rlc Water Heater or power vented
Reconne~ma of the S~.ce ]Entrance Cable, Meter Box, situations to receptacles
and li.t~ g, xttn~s due to siding / soffit ins~_..~on. Note., New Ser~ce
applian~ / r~.
Now ~ult t~r thc addition of A/C to ~ ~ dv~t~ a~' {house or the
Tho,vehe of~s wark ie $. .~5(5,c°
I hereby verify thi~ wod¢ will be ~ by an employe~ of this comptmy and further vedfy
the .r~o~-tkm / installation will bo dram in cmnpHnnc, ~ maa,.,~c-mm- and Electric code