HomeMy WebLinkAbout0102127-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 117 BROCKWAY AVE
Contractor THOMPSON HEATING AND COOLING S
~ue~ Z~-~G_as __] U oi~
System ~. NeTM ............ I
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
~J Forced Air J [~ Radiant
LJ Electric I J J Hot Water
Chimney Type ~ Chimney A ~ Chimney B
Heat Loss ~ As'Approved ~ Existing
BTU Rate ~ As Per Plan ~ Variable
Owner MARK R/DANIELLE WUEST
Category 501 - Residential-Air Conditioning
[] Electric ],
[] Replace_ ..............
[_d Steam I
[] Suppl.
(~ Direct Vent O Not Applicable
~1t Not Applicable
~ Other
[] Solar
L~J A/C
[] Con. Burner
Value
Value
No 102127
Create Date 06/11/2003
Plan
LJ Solid
Other
LJ Vent j
Use/Nature
of Work
SFRllnstalling A/C* TRuck EIV attached
Fees: Valuation
Issued By: ~
$1,045.00
Plan Approval
$0.00 Permit Fee Paid
$21.50
Date 06/11/2003
[] Permit Voided J ,
In the perfor~ this work, I~ to perform all work pursuant to rules governing the described construction.
/,~ .... I' Agent/Owner
Date
Address 901 OTTER Oshkosh WI 54901 -0 Telephone Number
920-426-3095
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications ~ill 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 m 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 Account System and have hdequate funds, check here
(£ you want this processed through your account N
JOB t m ss //?
CHECK [] ALL APPLICABLE
1~ CATEGORY
ngle Family []Duplex IZlMulti-Family F1R6ntal
[]Commercial
[]Industrial
FUEL ffJ,Gas FIElectric F1Solid SYSTEM FINew FIReplace
[=]Oil FISolar EIOther
TYPE
~Forced Air [2Radiant FISteam ~UC FIVent FIElectric F1Hot Water I:lSuppl. ECon. Burner
IS CHIMNEY BEING LINED F1No ~Yes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE F1Chimney A F1Chimney B F1Direct Vent
HEAT LOSS IZIAs Approved mExisting FINot Applicable
BTU RATE I-lAs Per Plan F1Variable FIOther Value
, ,,,---7--~
DESCRIPTION OF ALL WORK BEING DONE ~ _~~/c~_.>~
F1Other
VALUE (Including labor and all materials including light fixtures) $ /~ ~,~. ~'~
ELECTRICAL CONTRACTOR
[] For applicable projects, an Electric Install ation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh Wl 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
I (We) _ , . !C'.-
(Electrical Contractor Name)
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work
(Name o[ party contracted to)
at the following address: Ii tq
~ ' (A~l~ess where Work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the rePlacement of other permanently wired
Neappliances / fixtures.
w circuit for the addition of A/C to an individual dwelling unit (house or the
individual,systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $
I hereby verify this work will be performed by an employee of this company and further verify
the/r~onnection / installation will be done in compliance with manufacturer and Electric code
re/~I/~ments'
~S i~/~t'u'r~'o'f"Com'Xp~y Orfficer)' IPrih~'}Name' Of O~ficer) (ti)ate/)
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