HomeMy WebLinkAbout2003-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 1509 WALNUT ST
Contractor BLACK-HAAK 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 KLINGER PROPERTIES INC
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 O Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
104613
10/07/2003
Other
Vent J
Use/Nature SFR/Replace furnace, install A/C and install return from upper level. * EIV form from Krueger Electric.
of Work
Fees: Valuation
Issued By:
$4,500.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$72.50
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 PO BOX3070 APPLETON WI 54914 -3070 Telephone Number
(920) 757-9990
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
OCT
o
HVAC PERMIT APPLICATII:IR
Ail information after bold categories ~l~a~t.b~., , u~"~p prg~//~./~/T~7-
0F
Inco~lete applicafiom will not b~ roeesse~ ~ ~ tvt
Application(s) ~d fee(s) c~ be brought to Ci~ Hall, Room 205 or ~iled to ~ecfion S~ces, PO Box 1128,
Oshkosh WI 54903-1128. Co~encing work without p~it(s) ~I1 result in fees berg doubled or $100.00 plus ~e
no~al p~t fee, w~eh ev~ is ~eater.
OR
IfXbou are a contractor participating in the Permit fee Account System and have adequate funds, check here
if vou want this processed through your account ~
CItECK [] ALL APPLICABLE
USE CATEGORY
~.~Single Family" FIDuplel ~' F1Multi-Farnily [3Rental [2Conuner6ial
FUEL F1Gas
[:]Oil
FlIndustrial
[DElectric r~Solid SYSTEM [2]New
[DSolar FlOthe~ ' ' :'
[DReplace
TYPE
,i~orced Air F1Radiant [DSteam [~A/C [3Vent [DElectric
IS CHIMNEY BEING LINED II~o [:]Yes - LINER SIZE
Note: Ail chimneys shall be sized pe~ae BTU's being vented.
CBffMNEY TYPE rnChimney A [DChirnney B~' EIDirect Vent
I~..AT LOSS [DAs Approved [~}lExisting F1Not Applicable
BTU RATE j~ks Per Plan EVadable [DOther Value
DESCRirr,o OE ALL
[:]Hot Water [:]Suppl. [DCon. Bumer
& MANUFACTURER
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CON~CTOR " ~ '~
- [] For applicable projects, an l~lectfic In'~tallation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
Electric Installation Verification
~dcal Co.actor
(Address) (Ciw) ' (S~a~) (Zip Code)
(Ad.ss wh~e work ~11 be
~e natm~ of the work eons~sm of: {Check ~e vr Dcmfibo ~e Na~ of Work)
~ R~o~fion or n~ ci~uit for mplacm~i H~ PI~ ~or .~C Condmser.
. __ Rec~ti~ or new d~uit for r~lae¢~t EI~, Wa~ ~.
Rceom~tion of~e S~co En~o Cable, M~ Box. ~t~ations to ~t~le~ ~d
li~ting fixes du, ~ siding / ~ffi~ i~afion, Note: N~ S~icc
C~lc~ will rcq~m a s~atc ~it.
...... Reco~eetion or new mmuit lbr oth~ peii~au~tly.~ ~pli~c~ / ~xtums.
0~
The w. hm o£this work is $_~,~,.~'"0
hereby verify thi~ work. will be performed b~, an employee ofthi~ ¢omplmy and fm'th~ verify the
recon~ectmn / installation wlJ! bc dollc in complianc~ with manufaetltrer and El~c code
re~qUlrerncnts,
(Print Name of Officed