HomeMy WebLinkAbout0101166-HVAC (a/c)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1039 ALGOMA BLVD Owner PALMER REV L TRUST FLORENCE L
Contractor WESLEY HEATING & COOLING INC Category 501 - Residential-Air Conditioning
Fuel ~J Gas J ~J Oil L~J Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 2-ton CAC
No
Create Date
Plan
~J Solid
Vent
101166
05/01/2003
Use/Nature SFR/Install central air conditioner. *EIV form from Solar Electric.
of Work
Fees: Valuation
Issued By:
$1,900.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$33.50
Date 05/01/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1736 SAL STREET GREEN BAY WI 54302 -0
Telephone Number
(920) 468-6951/235-6
City of Oshkosh
Division oflnspecfion Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Pho~ (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
Alt infarmat/on after bold categories must be provided.
Incomplele applications will not be processed.
Application(s) and fee(s) can be brought to Cit3' Hall, Room 205 or ma/led to Inspection Services, PO Box 1128,.
Oshkosh WI 54903-! 128. Commencing work without permit(s) wilt result in fees being doubled or $1-00.00 plus the
normal permit fee, which ever is greater2
OR
~o.u are a cqnt~rac~or particivatin~ in the Permit .fee Aceou,~ Spstem and have adeauate £urlds, check here
~f. yo.u ,want this processed through your.ctcc.o~tnt ~. I ......
C~CK 1~ ALL APPLICABLE
USE CATEGORY
I~'ingl¢ Family C1Duplex
~Multi-Famity 12Rental DCommercial 12J~dustrial
FUEL FIGas ,t~¢c~c l-ISolid SYSTEM ~New l-lReplaee
I-lOll ElSolar ~Other
TYPE
FIForeed Air DRadiant EISteam~C CIVent FIElectric IlHot Water EISuppl. EICon. Burner
IS CHIMNEY BEING LINED ~gl~o {:IYes- LINER SIZE & MANUFACTURER
Note: Att chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE fflChimney A IZIChfmmey B F1Direct Vent CIOther
HEAT LOSS ~As Approved IlEx/sting l~Not Applicable
BTU RATE i'3As Per Plan ~Vaxiabte t~)ther Value__
DES.CRIPTION OF ,4LL WORK BEING
ELE~CAL CO~~OR ~L~ ~ ~etrie Inmllat~On Verifica~on f~rm at!ac~ed(~N~em~t)
~tectm'e~t in,tattatlon qnew/replacement e~tfpmem $hMI ~ done ~, Iice~.ed ~ntractors.
3/o2
tqAY 0 ? Z~O~ ,
The valu, of this workis $. ,~00- ~mO f
thc t~Onn~lion / ~afion ',viH b~ doae m ~c~ with mnmaacau~ nno c'm~n~ vom~ t