HomeMy WebLinkAbout0101561-HVAC (a/c)OSHKOSH
ON THE WATER
,Job Address 1209 HARNEY AVE
Contractor ANDRESEN SHEET METAL
Fuel ~J Gas ~
System ~J New
[~ Forced Air 1
~J Electric I
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner GERMAINE TANK
Category 501 - Residential-Air Conditioning
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney B O Direct Vent ~ Not Applicable
Existing ~ Not Applicable
Variable ~ Other
Value
Value
No
Create Date
Plan
L~ Solid
101561
05/16/2003
Other
Vent J
3 ton 10 seer
Use/Nature SFR/New a/c add on. *EIV for from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$1,700.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$30.50
Date 05/16/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2913 WITZEL AVE OSHKOSH WI 54904 -6539 Telephone Number
(920) 233-0323
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
_aAu 9o
RECEIVED
MAY
DEPARTMENT OF
HVAC PERI~i~f~~~~ENT
All information after bold categories must be provided.
Incomplete applications will not be Processed.
0 ,XH, KO/H
ON THE WATER
· 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.
I. f you.are..a contractor par~icipa, ting .in the .Permit fee dcOo. u. nt SYstem an~ .h~Ve a.d~uate_fun, ds', Yhe. ck here
.if yo~..want this processed, th{o. ugh your,, account r~ ,' ~ ' .- .. ,
l~mgle Family ~Duplex F1Multi-Family FIRental I-ICommercial Fllndustrial
mOil FISolar FIOther
TYPE
IDForced Air nRadiant nSteam ',~A/Cnvent nElectric I=lHot Water FlSuppl. I-iCon. Burner
IS CI~M2NEY BEING LINED nNo nYes - LINER SIZE/4~~& MANUFACTURER,
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE FIChimney A ?.~!mey B -~rect Vent FIOther
HEAT LOSS EJAs Approved t~Existing FINot Applicable
DESCRIPTION OF ALL WORK BEING DONE
,. , /v:&o ./¢C, ~/A ~,,,u ","'
(including labor and all materials including light fixtures) $
VALUE
[] For 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.
FROM : SECKAR ELECTR!C
~ Jun ~? ~]~ 08:48a
FAX NO. : 9202515950 Iul. 1~ 2002 09:54PM P1
Electric Installation Verification
--
~vo~en~~top~o~tieot~c~t/onwor~for M ~~ ~' . ~ ofP~y ~n~ted to)
(A~ss
~ ~ ~ of: (~k One or D~be ~ Na~e of ~)
~ ~e=~o~ or n~ drc~t for ~~:
~~ti~ o~ ~ geico ~e C~ Me~r
~ce C~Ics will ~ a
,,, ~~o~ ~n~ c~c~i flor ~e r~l~em~t ofo~er p~tly
N~ ~ for ~e a~i~ of~C
Oth~
The value, oft~s work is $~.
I hcteby v~'~y this WOrk w;lt be p~ed by ~ ~ploy~ of~is c~p~y ~d ~ ve~fy
(Si~m of C~y Office)
(Pr/~t Nam: of