HomeMy WebLinkAbout0101776-HVAC (registers & return)OSHKOSH
ON THE WATER
.lob Address 2353 COMET ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
RASMUSSEN'S HEATING & A/C INC
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner DEANNEBRENNAND
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101776
05/28/2003
Other J
Vent J
Use/Nature RENTAL/Install 2 supply registers and 1 return in the basement.
of Work
Fees: Valuation
Issued By:
$300.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 05/28/2003
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 Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
lax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
Q/HKO/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.
OR
If you are a contractor pa.rticipating in the Permit fee/lccount System and have adequate funds, check here
if you want this processed throtlgh )~our account ~.
CONTRACTOR
DATE :9''7''~ ''~3
CHECK [] ALL APPLICABLE
USE CATEGORY
I"lSingle Family I"lDuplcx
E]Multi-Family
I~Rental
E]Commercial
r'lIndustrial
FUEL I~Gas V1Electric VISolid SYSTEM CINew
VIOil VISolar ElOther
r'IReplace
E
~Fo~ed Air nRadiant I"lSteam l-lAIC I-IVent rlElectric
IS CHIMNEY BEING LINED ~o OYes - LINER SIZE
Note: Alt chimneys shall be sized per the BTU's being vented.
HEAT LOSS OAs Approved ' ' ONot Applicntble
BTU RATE OAs Per Plan E]Variable ~Y&er Value
WOm
EIHot Water E]Suppl.
& MANUFAC~R
nDirect Vent OOther
ElCon. Burner
VALUE (Including labor and all materials including light fixtures) $ TOO
ELECTRICAL CONTRACTOR ~
[] For applicable projects, an Electric Installation Verificati°n form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.