HomeMy WebLinkAbout0101879-HVACOSHKOSH
ON THE WATER
.lob Address 2777 CLOVER ST
Contractor AMERICAN HEATING & A C CO
Fuel ~J Gas ~
System ~J New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner THOMAS N RUSCH
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 ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101879
04/09/2003
Other J
Vent J
75M
Use/Nature NSFR/ Install furnace and air exchanger.
of Work
Fees: Valuation
Issued By:
$4,600.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$74.00
Date 06/02/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 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 ['5 I
Ali information after bold categories must be provided, t~' .(0 L~
Incomplete applications w~ll not be processed. ~ ~"~
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Semites, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pemit(s) will result in fees being doubled or $100.00 plus the
nomal pemit fee, which ever is ~eater.
OR
lf vou are a contractor participating in the Permit fee Account S~stem and have adequate funds, check here
if vou want this processed througl~ your account ~
JOB ADDRESS
owmR
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
~ingle Family UIDuplex
[2Multi-Family EIRental
F1Commercial
Fllndustrial
FUEL ~8~Gas FiElectric ElSolid SYSTEM J~ew FIReplace
[3Oil [2Solar FiOther
TYPE
JS~rced Air [3Radiant I'-ISteam EIA/C [~ent U1Electric IDHot Water FiSuppl. F1Con. Burner
IS CHIMNEY BEING LINED (~o I-lyes . LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CH/MNEYTYPE
HEATLOSS
BTU RATE
FIChimney A
FIAs Approved
FIAs Per Plan
°]5~LChimney B ElDirect Vent [3Other
ElExisting E1Not ApPlicable
I'-tVariable ii'Other Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
OR [] Electric Installation Verification form attached(If Replacement)
ElecMcal installation of new/replacement equipment shall be done by licensed contractors.
s/o2