HomeMy WebLinkAbout0104352 HOSHKOSH
ON THE WATER
.lob Address 2002 VlNLAND ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
ALL SEASONS QUALITY HTG & CLG
Oil
Owner DAVID/GLORIA GUTCHE SR
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 ~) Chimney B O 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
104352
09/23/2003
Other
Vent J
Use/Nature SFR/Furnace and A/C being replaced. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$3,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$63.50
Date 09/23/2003
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 3698 VINLAND RD OSHKOSH WI 54901 -0 Telephone Number
(920) 426-8090
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
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Serv/ces, 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
If you are a contractor participating in the Permit fee Account System and have adequate funds, .check here
if you want this processed through your account [-~
JOB ADDRESS
CONTRACTOR
DATE
CI4rECK ~ ALL APPLICABLE
USE CATEGORY
~Single Family F1Duplex
l-lMulti-Family r'lKental
IZICommercial
[2Industrial
FUEL ~as U1Electric FlSolid SYSTEM FtNew J~Replace
F1Oil F1Solar F1Other
Note: All ch/nmeys shall be sized per the BTU's being vented.
TYPE
~orced Air FIRadiant [Z1Steam ~AJC []Vent F1Electric F1Hot water F1Suppl. FICon. Burner
IS CHIMNEY BEING LINED [~qo r'lyes - LINER SIZE ~" & MANUFACTURER
F1Chimney A
I-IAs Approved
r-lAs Per Plan
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[2Chimney B
21~xisting
[2]Variable
DESCRIPTION OF ALL WORK BEING DONE
N irect Vent [Other
ot Applicable
F1Other Value
VALUE (Including labor and all materials including light fixtures) $ ~c~c__xD.,:~o__
ELECTRICAL CONTRACTOR 9 ~'~:~ ~-
~For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
_O/HKO. fH
Electric Installation Verification
(We) ffd. e,_x 'vu c..,
(Electrical Contractor Nmxqe)
(AddresS) (City) (State)
have been c°ntracted t° perf°rm electric installation work for ~
(Name of party contracted to)
at the foliowing address:
(Address where work will be performed)
The nature of the work consists of: (Check One ar Describe the Nature of Work)
Recmmection or new circuit for replacement Heating Plant and/or A/C Condenser.
_. Reconnection or new circtfit for replacement Electric Water Hearer or power vented
water heater.
__ Recormection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Servme
Entrance Cables will require a separate permit.
Recormection or new circuil 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 condominium), including required servxce
electrical outlets.
Other
(Zip Code)
The value of this work is $. /CE)- oO
I hereby verify this work will be performed by an employee of this company and fi~rther verify
the reconnection / installation wilt be done in compliance with manufacturer and Electric code
requirements.
Print Name of Officer) (Date
5/02