HomeMy WebLinkAbout0101417-HVAC (furnace & a/c)(~ CITY OF OSHKOSH No 101417
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 230 S EAGLE ST Owner JAMES W/BERNICE NORTON SR
Contractor AMERICAN HEATING & A C CO Category 502- Residential-Both
Fuel ~ Gas J ~ Oil L~ Electric ~ Solar I L~ Solid
System ~] New ~ ~] Replace ~ ~] Other
~ Forced Air I ~ Radiant L~ Steam ~ A/C I ~ Vent
~] Electric I ~] Hot Water L~ suppl. ~] Con. Burner 1
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value 0
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 50m btu furnac/lSm a/c
Create Date 05/12/2003
Plan
Use/Nature SFR/Replace furnace and central a/c. *EIV form from Seckar Electric.
of Work
Fees: Valuation $3,900.00 Plan Approval $0.00 Permit Fee Paid $63.50
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATFR
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 participatiqx in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account
I--1Multi-Family
nRental
JOB ADDRESS
OWNER ,_~/rr?
CONTRACTOR
CHECK ~ ALL APPLICABLE
USE CATEGORY
~ngle Family ~Duplex
FUEL ~as ElElectric nSolid SYSTEM
BOil F1Solar
TYPE
DATE
ElNew ~%j;~cep~ace
EIOther ?,A
t~orced Air nRadiant IZ1Steam~C FtVent nElectric IZIHot Water ElSuppt.nCon. Burner
IS CHIMNEY BEING LINED~ .~, o, I-lYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE F1Chimney A nChimney B ,J~rect Vent FIOther
HEAT LOSS I-lAs Approved dg~xisting F1Not Applicable
BTU RATE nAs Per Plan CIVariable
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ ,.~ ~0 f~
ELECTRICAL CONTRACTOR OR'~f~ectric Installation Verification form attached(If RePlacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
3/02
OffHKOff'H
ON THE W^IER
City of Oshkosh
Division of inspection S~rvices
215 Church Avenue
PO Box 1 t30
Oshkosh Wl 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(We) CO P/t,U '
(Electrical Con.actor N~e)
(Ad.ess) (City) (State) (Zip Code)
have been con~acted to peffo~ elec~c ~stallafion work for .~~/C~ [~~ ~& .
~e of p~y con~acted to)
at
me
following
(Ad.ess where work will be perfo~ed)
The nature of the work consists off (Check One or Describe the Nature of Work)
~'/ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection 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 condominium), including required service
electrical outlets.
Other
The value of this work is $
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Signatmle of Comp ""y Officer)
(Print Name of Officer)
(Date)
5/O2