HomeMy WebLinkAbout2003-HVAC(~ CITY OF OSHKOSH No 101416
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3800 PURPLE CREST DR Owner DEWEY HOMES INC
Contractor AMERICAN HEATING & A C CO Category 502- Residential-Both
Fuel ~J Gas ~ ~J Oil b~ Electric ~J Solar I L~ Solid
System ~J New ~ ~ Replace ~ ~ Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C I ~J Vent
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner 1
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value 0
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m furnace & 24m a/c
Create Date 03/12/2003
Plan
Use/Nature NSFR/Install furnace and central a/c.
of Work
Fees: Valuation $4,500.00 Plan Approval $0.00 Permit Fee Paid $72.50
Issued By: Date 05/12/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number (920) 235-8090
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084 ~"7~ ~4-~/~
HVAC PERMIT APPLICAT[ P .
All infomation after bold categories must be provid~;
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to Cily Ilall, Room 205 or mailed to Inspection Se~fces, PO Box 1128,
Oshkosh WI- 54903-1128. Commencing work without pemit(s) will result in fees being doubled or $100.00 plus the
no~al pemit fee, which ever is ~eater.
OR
~D~ou are a contractor~articipating in the Permit fee Accoztnt System and have adequate funds, check here
if you want this processed through Four account
JOB ADDRESS
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
~i~ingle Family [-1Duplex
F'IMulti-Family
IDRental F1Commerciat l--llndustrial
FUEL 'I~G a s F1Electric U1Solid SYSTEM ]~lew E1Replace
F1Oil F1Solar U]Other
PE C
rced Air EIRadiant t-lSteam ~/ FIVent I--1Electric U]ttot Water F1Suppl. F1Con. Burner
IS CHIMNEY BEING LINED ~.'o r-lYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[-lChirnney A
I-lAs Approved
l-lAs Per Plan
ElChimney B
ElExisting
UlVariable
~[Direct Vent r-lOther
,l~l~Iot Applicable
]~;t{Other Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
OR [] Electric Installation Verification form attached(If Replacement)
Electrical instaYation of new/replacement equipment shall be done by licensed contractors.
3/02