HomeMy WebLinkAbout0101497-HVAC (furnace & a/c)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1529 BUCHANAN AVE Owner JAMES E ZELHOFER
Contractor RASMUSSEN'S HEATING & A/C INC Category 502 - Residential-Both
Fuel ~J Gas J ~J Oil b~ 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 O Chimney B ~ 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 60m btu
No
Create Date
Plan
~J Solid
Vent
101497
05/15/2003
Use/Nature SFR/Replace furnace and a/c. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$4,800.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$74.00
Date 05/15/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number
920-235-6569
City of Oshkosh
Division of gnspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
OZFKOjH
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will 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 ,~ccount System and have adequate funds, Check here
if you want this processed through your account r~.
CONTRACTOR ~ ~o~-~n~-~
CHECK [] ALL APPLICABLE
USE CATEGORY
El/Single Family EIDuplex
FIMulfi-Family
E3Rental
DATE -15-03
RECEIVED
MAY 1 2003
DEPARTMENT OF
E]Con c iNIT¥ r
FUEL I~Gas FIElectric EISolid SYSTEM
EIOil F1Solar
ElNew [~eplaee
EIOther
TYPE
l~orced Air ElRacliant ElSteam [~A/C EIVent F1Electric
IS CltlMNEY BEING LINED E]No ~es - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
OHMNEY TYPE
i~EAT LOSS
BTU RATE
EIChimney A
EIAs Approved
I-lAs Per Plan
Elliot Water rlSuppl. ElCon. Burner
& MANUFACTURER
DESCRIPTION OF ALL WORK BEING DONE
[i~Chimney B EIDireet Vent ElOtber
El~0sfing 131~Jot Applicable
ElVariable I]tOther Value
VALUE (Ineluding labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR 5 t' m ~ K[e.c.*r cc.,
~or 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.
Electric Installation Verification
I (We).
~lootrioal Co~ Name)
have been oontractod to pea'roma e,l~o installation work for
(np coae)'
(Name of party contracted to)
at the following ad&ess:
't3
(Addre~ w~ wo~c wm be perfo~ed)
The nature of the work consists of:. ( .Cheek One or Do~oribo the Nature of Work)
The vahm ofthis work is $ .~, oa
I hereby verify this woflc will be performed by an employee of this company and further verify
the rec, mmection / ~on will be done in con~iian~ with manufacturer and Electric code