HomeMy WebLinkAbout0104639-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 408 W 6TH AVE
Contractor
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
THOMPSON HEATING AND COOLING SI
Oil
Owner MARCIA D HAEDT
Category 501 - Residential-Air Conditioning
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 ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
104639
10/07/2003
Other
Vent J
Use/Nature SFR/Install Central Air.* EIV from T Puck Electric attached
of Work
Fees: Valuation
Issued By:
$1,350.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$26.00
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 901 OTTER Oshkosh WI 54901 -0 Telephone Number
920-426-3095
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-I 130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete 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 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
H'¥ou are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through your account ~
CHECK [] ALL APPLICABLE
USE CATEGORY
~Single Family [2Duplex [2Multi-Family
[2Rental
[3Commercial
mIndustrial
FUEL ~Gas []Electric [3Solid
F1Oil F1Solar
SYSTEM
RL,New [3Replace
mOther
TYPE
~Forced Air []Radiant F1Steam C []Vent [3Electric
IS CHIMNEY BEING LINED rqNo EYes - LINER SIZE
Note: All chimeys shall be sized per the BTU's being vented.
[]Hot Water FISuppl.
& MANUFACTURER
[3Con. Burner
CIIIMNEY TYPE F1Chimney A []Chimney B [3Direct Vent
HEAT LOSS V1As Approved V1Existing F1Not Applicable
BTU RATE [3As Per Plan [3Variable rqOther Value
DESCRIPTION OF ALL WORK BEING DONE
[]Other
VALUE (Including labor and all materials inclUding light fixtgres) $ /~t~, ~
~For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Eleclrieal Permit is required.
9/02
Electric Installation Verification
(1) [
(Electrical Contractor Name}
(Address) (City) (State)
have been4:Ontraeted to perform electric installanon work for ~
at the following address:
(Zip Code)
(Name of party contracted to)
(Address where work will be perf6nned)
The nature of the work consists of' (Check One or Describe the Nature of Work)
Reconn~ction or new circuit for replacement Electric Water Heater. ~
Reconnoetion 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,
Reconnection or new circuit lbr other permanently wired appliances / fixtures.
Other
The value of this work is $ i'~t~' ~
I hereby verify this work will be performed by an employee of this company and further verify the
reconneetio~n / installation will be done in compliance with manufacturer and Electric code
requi~+e~ats. ' .