HomeMy WebLinkAbout0101795-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 1855 CLIFFVlEW CT
Contractor RYF HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner HAROLD R/PAMELA SALZER JR
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101795
05/28/2003
Other J
Vent J
Use/Nature SFR/Install new central air. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,185.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$38.00
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 240 MAIN ST PO BOX 450 WINNECONNE WI 54986 -450 Telephone Number
582-4451
::::: '; .O/HKO,/"H
ON THE WATER
' HVAC PERMIT APPLICATION ....
All information after bold categories must be provided, ·:
~!!:~ :" . Incomplete applications will not be processed.
Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
g work without permit(s) will result in fees being doubled or $100.00 plus the
If you are a contractor participating in the Permit fee Account System and have 'adequate funds, check here
if.you want this processed through your account N
JOB ADDRESS
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
" ' :-; ::-"~;~'~,'~i i L'
USE CATEGORY ::
~Single Family
FUEL ~Gas' I-IElectric I-ISolid
T~Oil I-ISolar
TYPE' !'!;'i'"75 i.' ".:. i~':?,::!ii~]~::~:,
E]Forced Air QRadiant EISteam
I-IMulti-Family
I"]Vent
DATE
ClRental i-l~0mmemiai'- Qlndustrial
;.! '
SYSTEM F1New [~Leplace
DOther
E[Electric EIHot Water FISuppl. ~Con. Burner
IS CttIMNEY BEING LINED FINo FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
' A FIChimney B FIDirect Vent
5 FIAS Approved FIExisting FINot Applicable
BTU RATE '. i Fl_As Per p,.!an EIVariable FlOther Value
& MANUFACTURER
E]Other
, VALUE (~cluding labor and ali materials including light Fatures) $ ~ ! g ~.
applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
If not attached or not applicable, a separate Electrical Permit is required.
.,i ] , :, .,% ; ~'---,-~.;" .-
Electric Installation Verification
'- "~t~¢t~o,! Contractor
(Adcke~) (City) (S'.ate) (Zip Code)
~me ofp~ ~n~actcd to)
(Address whcrc work will be petformcd)
The narare of the work consia*.s of: (Check One or Describe the Nature of Work)
ReoormecUon or now circuit for r~laceme~ Heatin8 Plant and'or A/C Condenser.
l~co~ or new circuit for replac~ut Bleclric Wa*.e: He~ or power vented
w~r heat=.
Recormccfio~. of the gert, ice BnU'ance Cable, Meter Box, al~'a~ons to receptacles
amd lighting fixiurcs due to siding / ~ofth installation. Note: New service
Entrance Cables will require a separate poxmit,
R.eco~ecgon or ner~ circuit for the replacement of other pcrmanently wired
apptlance~ / flxutres.
New cirv~t for the addition of A/C to an ~ndividual dwellS.8 unit (house or ~e
iudivi~ systems in a duplex or condominium), in'-lading required ~erviee
~teotrical outlets,
Other
The value oftl~is work ia $_
I hcroby v~f~ this work will be porfon~ed by an employee of this company ~d ~ vefi~
t~ ~:.~ / i~on wi~ be ~e in Co~ce wi~ m~ufacmrer ~nd Et~e ~e
Name of Officer)
3/92