HomeMy WebLinkAbout0102198-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
Job Address 1229 JEFFERSON ST
Contractor PAUL'S HEATING
Fuel b~J Gas I
System [] New
Forced Air J
CITY OF OSHKOSH
No 102198
HVAC PERMIT - APPLICATION AND RECORD
Electric
Chimney Type
Heat Loss
BTU Rate
Use/Nature IFIW
of I/Vork
Chimney A
~ As Approved
~ As Per Plan
L-J Radiant I
Hot Water
Chimney B
(_~ Existing
(.~ Variable
Owner
Category
CHRISTOPHER G RISTOW
502 - Residential-Both
Create Date 06/13/2003
Plan
[] Electric 1 [] Solar
[] Replace I [] Other
LJ Steam I ½ NC
[] Suppl. I [~ Con. Burner
Direct Vent (.~ Not Applicable
O Not Applicable t Value 0
I~ Other I Value
Replace furnace and add a/c. *ElY form from Seckar Electric.
Fees: Valuation
Issued By: ~
$3,500.00 Plan Approval
$0.00 Permit Fee Paid
$57.50
Date 06/13/2003
[] Permit Voided J
In the performanceFo{ this work, I agree to perform all work pursuant to rules governing the described construction.
- 4.
Signature · ~
t ~ '" - Agent/Owner
Date
Address 1534 Grove St Oshkosh WI 54901 -0 Telephone Number 920-651-9730
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
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON TH~ WATFR
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I 128. 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 participating in the Permit .fee Account System and have adequate funds, check here
if you want this processed throuKh your account
Amm ss /aa, 8
CHECK [] ALL APPLICABLE
USE_CATEGORY
[~ngle Family nDuplex
nMulti-Family
nRental V1Commercial [2Industrial
FUEL ~as nElectric nSolid SYSTEM F1New I~eplace
nOil FISolar nOther
~orced Air VIRadiant VISteam []t~C VIVent nElectric FIHot Water [] Suppl. []Con. Burner
IS CHIMNEY BEING LINED []No [[~es - LINER SIZE &] t' ~ & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[]Chimney A
[]As Approved
nAs Per Plan
c[~h~mney B
[]Existing
[]Variable
[]Direct Vent
FINot Applicable
nOther Value
nOther
DESCRIPTION OF' ALL WORK BEING DONE TL,,. cCq'c,,b( ~/~,~ f--t/~- ~fo, c <._c~q....,~)
VALUE (Including labor and all materials including light fixtures)
ELEC~tlCAL CONTRACTOR ..~_C_{/mc~,~. ~ C'~-
/U,~For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
/ attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
O/HKO/H
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
I (We)
(Electrical Contractor Name)
(Address) (City) (State)
have been contracted to perform electric installation work for
(Name of party contracted to)
at the following address: . /~;2.~ O~~...%(3~
(Address where work will be performed)
(Zip Code)
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
appliances / fixtures.
New 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 ~ 00[ 0~
t hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(SignatUre of IGompany officer)
(Print Name of Officer) (Date)
5/02