HomeMy WebLinkAbout0104615-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 738 W 6TH AVE
Contractor AMERICAN HEATING & A C CO
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Owner FRANCIS N POESCHL
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO 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
No
Create Date
Plan
L~ Solid
104615
10/07/2003
Other
Vent J
75m
Use/Nature SFR/Replace 75m btu furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,400.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$41.00
Date 10/07/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number
(920) 235-8090
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 performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
OCT o T 2oo O/HKO/H
HVAC PERMIT APPIDI~T OF
All information after bold ca~lm.ri~ksllZbk'fii&~kthd~
Incomplete applications ~l~e~l:t~'LI3~
Application(s) and fee(s) can be brought to City t lall, 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, which ever is greater.
OR
If VoI~ are a contractor~__q_£li__~jp_a~(!!g_i_~L~lje ~'.e?~jt~_e_e_,J_cx~.!~nt_S3'.Lt?nt_and ha__ve adequate funds, check here
~f2'o~. )!'a~ tbis~proc~e-ss~e_d.__t[l!70ttgh 3??5
OWNER
CtlECK I~ ALL API'I,ICABI,E
USE CATEGORY
j~ngle Family ElDuplcx
C]Multi-Familv [DRcntal
EICommercial
Fllndustrial
FUEl, ~as El F, lectric USl~lid SYSTEM FINew ,~eplace
[21Oil FISolar ClOther
.oPE
reed Air UlRadiant UlSteam UA/(' UlVent U]Elcctric Ultlot Walcr USuppl. UlCon. Burner
IS CIIIMNEY BEING I,INED U]No ~'es-- - LINER SIZE___~_.¢_'_. & MANUFACTURER
Note: All chifinneys shall be sized per the I~TI.I's beina vented.
CHIMNEY TYPE EIChimney A ElChimney B ~Sq:~rect Vent UlOther
HEAT LOSS UlAs Approved ~tlii. xisting [DNot Applicable
BTU RATE U1As Per Plan E]Variahle ~i3_...Olhcr Value
I)ESCRIPTION OF AI,L WORK BEING ')ONE__/~_e/o //~-~- 7/~
VAI,I~E (including: labor and all materials inch,ding lilzht fixture~) $_ .4~.?L~90 ~
El .ECTRICAI, CONTRA(TTOR O~R f)~71ectric Installation Verification form attached(If Replacement)
Elecr ca n~ al at on of new/replacement equipment shall be done &*, licensed contractors,
Electric Installation Verification
(Electrical Con,actor N~)
(Ad.ss) (City) (Stae) (Zip C~e)
have b~ con~acted to perfo~ ~l~tfic insallation woi for .~ [C~ ~ ~,
~c ofP~y con~t~ to)
athcfollowingad~ess: ~ff~ fi, ~ ~
(Ad&ess where work will be ~o~ed)
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.
Rcconneetion 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 hereby verify this work wilt be performed by an employee of this company and further verify
thc reconnecfion / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer) (Date)
5/O2