HomeMy WebLinkAbout0102159-HVAC(~ CITY OF OSHKOSH No
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1511 MCCURDY ST Owner JAMES R HEINBIGNER
Contractor AMERICAN HEATING & A C CO Category 502- Residential-Both
Fuel ~J Gas ~ ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m- 24m a/c
Create Date
Plan
~J Solid
Vent
102159
06/12/2003
Use/Nature SFR/Replace 75m btu furnace and add 2 ton central a/c. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$3,900.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$63.50
Date 06/12/2003
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 ~f Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
JUN 1 2 2003
.,?ART ENT OF
h AR'rAl Ebff
001VlMUNITY DEVELOPMENT
HVAC PERMIT APPLICATION
All mfo~tio~ afte~ hold catego[ies must ho p~ovMed.
Incomplete applications ~i]] not be processed.
O/HKO/H
ON THF ',.A/ATFR
Application(s) and fee(s) can be brought to City ttall. Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI. 54903-1128. Commencing work without permit(s) ~vill result in 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 adequate funds, check here
~f vou want this processed through your account [--]
OWNER
CONT CTOR
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
l~ngle Family F1Duplex
F-lMulti-Family
I-1Rental I-1Commercial Ellndustrial
FUEL '}~G as UlElectric l-ISolid SYSTEM F1New
FlOil UISolar UIOther
~*,eplace
TYPE
[~orced Air F-IRadiant FISteam I~C UlVent UlElectric FlHot Water F1Suppl. F1Con. Burner
IS CHIMNEY BEING LINED 1~o I-lYes - LINER SIZE
Note: All chimneys shall be siZed per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEATLOSS
BTU RATE
EIChimneY A FIChimney B 4g~-D'h'ect Vent F1Other
F1As Approved l~'xisting [2]Not Applicable
UIAs Per Plan [2]Variable ~ther Value .t~'_,~jT.e(/'O .--
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
~Electric Installation Verification form attached(If Replacement)
OR
ElectRcal installation of new/replacement equipment shall be done by licensed contractors.
~/o~
Electric Installation Verification
(El~c~ Con.actor N~)
(Address) (City) (State) (Zip Code)
have been contracted to peffo~ clothe insaallafion work for
(Ad~e~ where ~rk Mil be peffo~ed)
~e na~ of ~e work consis~ oL' (Ch~k One or Describe ~e Na~e of Wo~)
~ R~o~ection or n~ circuit for r~la~ent Hea~g Pl~t ~&or ~C Conduct.
..... Reco~fion or new cim~t for r~lacment El~c Water H~ter or pow~ v~
water heater.
R~ecfion of~e Se~ice En~ce Cable, Met,r ~x, ~teraiom to ~tacles
~d li~fing fixt~ due to siding / soffit ~mIl~ion. Note: New Se~ce
Enff~ce Cables will r~uire a s~ate p~iL
R~eetion or new circuit for ~e r~lac~em of o~er pem~tly
appli~ces / fixt~es.
~ New ckc~t for the addition of ~C t0 ~ individual dwelling unit ~o~e or the
individual systems in a duplex or condominim), including r~uir~ s~ice
el~ffical outlets.
Omer
The value of this work is $
I hereby verify this work will be perfonned by an employee of this company and further verify
the reconnection / installation wilt be done in compliance with manufacturer and Electric code
requirements.
(Signatm/e of Company Officer)
(Print Name of Officer)
(Date)
5/02