HomeMy WebLinkAbout0102533-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 1513 BISMARCKAVE
Contractor DRUCK'S PLBG & HTG & CLG
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner RICHARD/KATHRYN HOFFMAN
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102533
06/30/2003
Other J
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Heritage Electric.
of Work
Fees: Valuation
Issued By:
$2,600.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$44.00
Date 06/30/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 504 3RD ST P O BOX 355 MENASHA WI 54952 - 0
Telephone Number
(920) 426-2654
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, wz s4903-z130
Fax # (920) 236-5084
~AC PERMIT APPLICATION
CiRCLE ALL APPLICABLE
FUEL ~ OIL ELECTRIC SOLAR
SYSTEM NEW ~ OTHER
TYPE ~AIR~ RADIANT STEAM
ELECTRIC HOT WATER SUPPL.
A/C
IS CHIMNEY BEING LINED ~/6/ LINER SIZE
Note: Ail chimneys shall be sized per the BTU's being vented.
CHIHNEY TYPE CHIMNEY A C~MNEY__~
HEAT LOSS AS APPROVED
BTU RATE AS PER PLAN ~~LE>
NATURE OF WORK:
COMMERCIAL
SOLID
II{DUSTRIAL
VENT
CON. BURNER
MANUFACTURER
DIRECT VENT
NOT APPLICABLE
OTHER VALUE
OTHER
.VALUE (Includin~ labor and materials) $ /~~D
ELECT~ZC~ CO~RACTOR //~,< ///Z~ Z~L~t//~/ ~
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 tO $1,000.00 ....................................................................................................................... $20.00
$1,000.01 to $10,000.00 ....................................................................................... $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 .............................................................................................. $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ................................................................................................................... $305.00 plus $0.50
per $100.00 valuation or part thereof
Submit payment with application. Failure to pay within 30 days will result in
fees being, doubled or $100.00 plus the normal permit fee, which ever'is
greater.
Electric Installation Verification
(Zip code)
lmve been contracted to pe~l'orrn ~lectric installation work for ~/~,,?e'~$'
(~la~ae ofpaa'ty c~ntr~toti to)
(Addr,~ where work will b~ perl~ormed)
The nalw:e ofth~ work consists of: (Ch~k On~ or Describ~ tl~ N~ of Work)
Recorme~lim: or new circuit for ~eplacemem Heatinll Phmt and/oc
P~ecolmection or new cirouit for repla~emeui Electric Wamr Heater,
Recotmection o£~e Semce Entrance C~ble, M~sr Box, alterations to
lishRn~ fixt'",n~ due to siding / soffit insudlalioo. Note: N~ Service Er~tr~mce
Cabl~ will r~:fuir~ a s~ar~te permit
Re, oonnection or new circuit for oth~ pennmcmly wired appliane.,s /
Thc v~llue of'this work is $
I hor~b¥ vexify this work will be perfbrmed by an employee of this ¢omp~riy anti farther veril9 the
reaonnection / i~stall~tion will b~ done in ¢ompli~n~ with mamff~turar and l~leetric code
tsisn~,~ of comply omni ....
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