HomeMy WebLinkAbout2003-HVAC (furnace-A/C) CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner WERNER F SIELEMANN
OSHKOSH
ON THE WATER
Job Address 1023 PIERCE AVE
Contractor WESLEY HEATING & COOLING INC Category 501 - Residential-Air Conditioning
Fuel Iv*[ Gas I I ] Oil I I~1 Electric I I..J Solar
System [] New j [] Replace
~ ForoadAir gJ Radiant j L] Steam
I IElectdc I I IH°tWaterI I ISuppk I I iCon-Burner I
Chimney Type ~ ChimneyA { ~ Chimney B O DirectVent
Heat Loss ~ ~ As Approved O Existing {.~ Not Applicable I Value
BTU Rate I~ ~ As Per Plan ~ ~ Vadable ~ Other I Value
No 103281
Create Date 08/04/2003
Plan
[] Other J
LJ vent
Use/Nature ;FPJ Install furnace and central air conditioner. *EIV form from Solar Electric.
of Work
Fees: Valuation $4,500.00 Plan Approval $0.00 Permit Fee Paid $72.50
Issued By: Date 08/04/2003
[] Permit Voided
In the performance of this work, I agree to perform all work pumuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1736 SAL STREET GREEN BAY WI 54302 -0
Telephone Number
(920) 468-6951/235-(
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not pe~ormed within two business days from the time the project is ready.
3~! 25TM O~ ll:20a ~HC OSH 2~5-7550 po!
City of O~hkosh
Division of Inspection Services
P.O. Box 11:30
Oshkosh, WI 54903-1130
Phono (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All infomaation after bold categories must be provided.
Incomplete applications will not be ptocessecL
F3_/'HKO/H
· 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 in fees being doubled or $100.00 plus the
normal permit fee, whioh ever is greater.
OR
If You are a contractor participating in the Permit fee ,~ccoant System and have adequate lands, check here
i[~ou want thi$ processed through ~our account [~
co e. cxoa /¢e, ¢
CltECK [] ALL APPLICABLE
m A
TEGORY
lc Family
FUEL
ElOil
IZlDuplex [2]Multi-Family r"lRental
]~loeCthC ClSolid SYSTEM
lar
~orced Air F1Radiant []Steam ~C rnVent [],Electric
1S CHIMNEY BEING LIiNEDr~o [] ,Y,,es - LINER SIZE
Note: All chimneys shall be sized i~r~e BTU s being vented.
E]Commercial Ellndustrial
FlHot water FlSuppl. F1Con. Burner
& MANUFACTURER
CHIMNEY TYPE nChimney A .[]Chimney B
HEAT LOSS []As Approved [~isting
BTU RATE []As Per Plan F1Variable
~J~irect Vent [3Other
DNot Applicable
r-lOther Value ~/ ~
DESCRIPTION OF ALL WORK BEING DONE
VALUE (including labor and all materials including light fixtures) $
,.~ror applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Pein'fit is required.
J~l* ~5-03 ll:13a ItIHC OSH
235-?550
p.1
Electric Installation Verification
-- (Eleetfica~ Conaactor Name) -
/ ~p~c~ /
~ O~er
The y~tu= oft his work is S ~D~. E';~
! hereby v~x~, this work will bo perfoxmed by an ~nplolme of ggs t:O~l~ly and ~ verify
the .~w-onn~ziofl ! inatallation will bc done h compliance ~ rmu~factui~ and l!lectric
~:lUZrCmeflts.
(Px~nt l~amo ofOffir, m-) ~ ' (Da~)