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Home My WebLink About0104353-HVAC (furnace)OSHKOSH ON THE WATER .lob Address 1515 EVANS ST Contractor Fuel [~J Gas ~ System ~J New CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ALL SEASONS QUALITY HTG & CLG Oil Owner RONALD A GUTZMAN Category 500- Residential-Heating & Ventilating 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 104353 09/23/2003 Other Vent J Use/Nature SFR/Replace furnace. *EIV form from Drexler Electric. of Work Fees: Valuation Issued By: $3,420.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $57.50 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 Sc~rvices P.O. Box 1 I30 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 HVAC PERMIT APPLICATION All info~tion after bold categories mnst be prov~,ded. I~complcte applications ~ll 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 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 Am)R SS OWNER CONTRACTOR DATE CHECK [] ALL APPLICABLE USE CATEGORY fl~'Single Family [=lDuplex ElMulti-Family DRental [:]Commercial Ellndustrial FUEL /l~Gas [3Electric nSolid SYSTEM [2]New ~Replace FIOil F1Solar F1Other TYPE J~Forced Air FIRadiant [3Steam F1A/C FIVent F1Electric F1Hot Water F1Suppl. IS CHIMNEY BEING LINED/~o [2lYes - LINER SIZE. & MANUFACTURER Note: Ail chimneys shall be sized per the BTU's being vented. ~.~ c~ ~ CHIMNEY TYPE [3Chimney A F1Chimney B [~t~rect Vent [3Other I{EAT LOSS I-lAs Approved ~xisting [3NOt Applicable BTU RATE [3As Per Plan [3Variable [3Other Value DESCRIPTION OF ALL WORK BEING DONE ~IL~-- ~4-o& [3Con. Burner VALUE (Including labor and all materials including light fixtures) $ ~ ~k'~O, ~-- ELECTRICAL CONTRACTOR ~t~.~. {~ ~ f~'~ ~For applicable projects, a~ Elec~c ~stallafion Verification fo~, si~ed by ~e Elec~cal Con,actor, must be auached. If not a~ached oi not applicable, a sep~ate Elec~cal Pemit is required. 9/02 OJHKOj H Electric Installation Verification (We) :ETd c_, (Addres§) (Electrical Contractor Nm~ae) (City) (State) (Zip Code~ have been contracted to perform electric installation work for ~/-J--~F_,~5o~3 (Name of party contracted to) at the following address: / 5'-/5'- (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 for replacement Heating Plant and/or A/C Condenser. Recormection or new circuit for replacement Electric Water Heater or power vented water heater. Recormection of the Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffi~ installation. Note: New Service Entrance Cables will require a separate permit. Recormection 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 condom/mum), including required service electrical outlets. Other The value of this work is $. ~_ o:g I hereby verify this work will be performed by an employee oft. his company and further verify the recormection / installation will be done in compliance with manufacturer and Electric code requirements. (Print Name of Officer) (Date) 5/02