HomeMy WebLinkAbout2013-HVAC (furance & a/c) �
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/�'� CITY OF OSHKOSH rvo 156580 `
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OSHKOSH HVAC PERMIT -APPLICATION AND RECORD E
ON THE WATER
JobAddress 1912 ROOSEVELTAVE Owner JAMES E RABE Create Date 07/08/2013
Contractor RASMUSSEN'S HEATING&A/C INC Category 502-Residential-Both Plan
inspector John Zarate
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Fuel ✓ Gas Oil Electric � Sola�� Solid_
System � New � ✓ Replace Other_ _�
✓ Forced Air Radiant Steam ✓ A/C �Vent i
Electric Hot Water Suppl. � Con. Burner I
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
Heat Loss As Approved � Existing � Not Applicable Value __
BTU Rate As Per Plan � Variable � Other Value 60,000
Use/Nature FR/REPLACE FURNACE AND A/C, ELECTRICIAN IS HULLAR EIECTRIC **check#5279
of Work �!�
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Fees: Valuation $6,960.00 Plan Approval $0.00 Permit Fee Paid $126.00 -
Issued By: (�1 Date 07/08/2013
❑ Permit Voided I Parcel Id#1212700000
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 se any ne ary approvals before starting such activity.
Signature ^ i���� Date �/3
AgenUOwner
Address PO BOX 1158 OSHKOSH WI 54903 -1158 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.
City of Oshkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 O HKO H
CV T-1F -�•:i�iFR €.
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 2Q5 0�mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1 1 28. Commencing work v�t�thout permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater. -
OR
I[,you are a contractor participating fn the Permit fee Account Svstem and have adequate funds, check here
if vou want this orocessed through vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form,signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be snbmitied
with the permit application. Applications snbmitted without an EIV when such is required,wi11 not be #
processed for Pertnit Issnance aud will be retaxned for completion.
DATE �— �'/,,�
JOB ADDRESS i 9�a Ro9����+ ���
OWNER__�'aw�eS Ra�G
CONTRACTOR RaS►�►�u55���5 I-�V/��.
CHECK�ALL APPLICABLE
USE CATEGORY
OSingle Family ❑Duplex ❑Multi-Family �Rental ❑Commercial ❑Industrial
FLJEL O�Gas ❑Electric ❑Solid SYSTEM ❑New �eplace
❑Oil ❑Solar ❑Other
�ForEced Air ❑Radiant ❑Steam �A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con.Burner
IS CHIMNEY BEING LINED �No PfYes -LINER SIZE ��_�MANUFACTURER �IGx� ��hu�
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A �himney B ❑Direct Vent ❑Other
HEAT LOSS ❑As Approved �xisting �Not Applicable
BTU RATE ❑As Per Plan ❑Variable C�Other Value �0�,OG1D
DESCRIPTION/SCOPE OF ALL WORK BEING DONE ���Iac.t,. �urv►a.c.e. 0.v�c� lt�fC-
VALUE(Including labor and materials)$ �� 960•�
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)���`G�( F�G��f`�C� _
o�/o�
�d� �� 5�-7`�