HomeMy WebLinkAbout0102301-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 24 W 11TH AVE
Contractor HIGGINS HEATING
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 NENG THAO XIONG
Category 502- Residential-Both
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
102301
06/04/2003
Other J
Vent J
Use/Nature SFR/Install new A/C. *EIV form from Witzke Electric.
of Work
Fees: Valuation
Issued By:
$1,150.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$23.00
Date 06/19/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 9590 N Oakwood Ave Neenah WI 54956 -0
Telephone Number
920-231-4039/757-6
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 549034130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incor~lete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus
normal permit fee, which ever is greater.
OR -
If you are a contractor participating in the Permit fee Account System and..have ade. quate funds, check here
(f ¥ou want this processed through, your account ~'~
Dm SS Q 6/
Ow R O
DATE d''~ /7/'- 0,..~
CONTRACTOR /'~"/~
CHECK ~ ALL APPLICABLE
U. S~CATEGORY
[~t~ingle Family E]Duplex ElMulfi-Family ElRemal E] Commercial [-llndustrial
FUEL ~s I-1EIectric [3Solid SYSTEM [~ew [3Replace
r-lOll ElSolar EIOther
~oorEced Air [3Radiant I-ISteam ~'~C [3Vent [3Electric EIHot Water r-ISuppl. [3Con. Burner
IS CHIMNEY BErG LINED [3No EYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFA~
CI-I~I2VEY TYPE I-IChimney A [3Chimney B E]Direct Vent
HEAT LOSS I-lAs Approved ElExisting ' EINot Applicable
BTU RATE [3As Per Plan [3Vax/able I-IOther Value
~Other
DESCRIPTION OF ALL WORK BEING DONE ~f'~' t g~g..~A~ ~'/,'q ~
~ For applicable projects, an Elcc~c ~s~allati~ Verification fo~, si~ed by the Elec~ ~on~actor, ~st be
a~ched, ffno~ a~ched or no~ applicable, a sepa~te Elec~cal P~-afit is req~d.
I'd ~OOG-LSL-O~6 su$~H
eLI:GO ~0 ~0 un_r
Electric Installation Verification
(Electrical Contrac~ Name)
- ~f P~
(Ad~s wh~e work Wil~be p~o~ed)
of~ we& co~a~s off (Ch~k ~ or D~gbe ~= Na~ of Wo~)
R~e~on or new ~cdt for ~l~em~t Here Pl~t
R~fion ~ n~ ckcdt for r~lacem~t ~l~c Wa~r
water heater.
Reco~i~ of ~e So,ice En~e Cable. Meter Box. alte~tio~
~d li~g flx~ due to side/soffi~ ~ion.
~ce Cables ~11 ~quk~ a s~ste
Rcco~on or n~ dr~t for ~e replacement of o~ p~tly
~pl~s / fixtures.
N~w c~t-~r ~ ~fion of~C to ~ ind~id~l d~el[i~ unit ~o~ or the
~~ ~ ~ a d~l=x or c~d~). ~cl~ ~ ~icc
The value o£this work is $~.
t hereby veri~ this work will be performed by ail entployee of this company n.nd ~urthcr verify
the reconnecdon / insutllatiou will be done in compliance with m~ufnaurer and EIec~= code
r~uirements.
--iSignattu-¢ ol' Company Officer)
Name o(Officer) (Date)
-- a'~ EOOG-&S&-O~6 su!22!H JJeC eLI:60 ~0 ~0 unr