HomeMy WebLinkAbout0104942-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 1785 CHATHAM DR
Contractor VANS HEATING & A/C INC
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner ROBERT/MARGARET RIECKMAN TRUST
Category 501 - Residential-Air Conditioning
L~ Electric
New ] ~] Replace ]
Forced Air ] ~ Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~) 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
~ Solid
104942
10/24/2003
Other ]
Vent
Use/Nature SFR/Replace A/C. *EIV form from Concept Services.
of Work
Fees: Valuation
Issued By:
$1,495.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$27.50
Date 10/24/2003
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 525 BUTLER ST DEPERE WI 54115 -5426 Telephone Number
(920) 336-2816
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.
~- 0CT-~0-2003 10:llA FROM:
TO:lg20720~G~ R:2~2
Division of lr~pectioa Services '
P.O. Box 1130
Os~osh, WI ~490~- 11~0
Phone (920) 236,5050
Fax (920) 236-5084
HVAO PERMIT APPLIOATION
All infom~on a~e~ bold categories
Ncomple~ applications w~l no~ be p~~D~a ~.
* Application{~) and fee(s) can b~ brought to C~ Hall, Room 205 or mailed to ln~ct~ ~0~I 128,
O~hko~h WI 54903-1128. Co~ncing work without pe~i~(s) will result in fee~ ~ei~g doubled o~00 plm the
n0mal pemit fee, whi*h ~v~r i~
OR
lf vou are a contractor partictpat~ng tn the Permit fe~ ~ecaunt ~stem and have adequate funds, check here
OWNER .... Ee
Ci'H~CK Ol ALL APPLICABLE
//~ CATEGORY
ngle Family
FIrEL (~as
IDOil
C3Duplex IZlMulti-Family FIRcnlal ClCommercial [3 Inclustriil
~Electri¢ ~Solid SYSTEM r-INew
1~5olat C1Other
ClForoed Air [-IRadiant CISteam~A/C rlVent I-IElcctri¢ I-IHot Water l-lSnppl. E3Con. Burner
IS CHIMNEY BEING LINED I-1No C]Ye~ - LINER SIZE
Note: All eNm~eys ~hall be sized pet the BTU's being vented,
CHIMNEY TYPE
I-I~AT LOSS
BTU RATE
& MANUFACTURER
ElChinmcy A ClChirnney B ElDirect Vent EIOtht'r
t-lAs Approved 13F, xisting r-lNot Applicable
[2As Per Plan [2Variable CIOthee
DESCRIPTION OF ALL WORK BEING DONE
YALUE {Including labor and all material* including llsht fixtures) $ / q 7~7. OO
. : ~ .... o m attached(IfR~pla~=~nO
3/02
~. 0CT~20-8003 10:11A FROM: TO:lg207808644 P:lx2
Electric InstaUafion Verification
(A~) (Ci~) ($m~) (Zip
h~cbecncon~ct~p~omd~c~afionworkfor ~ ~,~q
~e of~ c~ted ~o)
{~ wh~ w~ will ~ p~fu, m~) .....
of~e wo~ ~ off (~enk ~e ~ ~be ~e N~ of Wo~)
R~on ornew ~t ~r ~t EI~c Wg~r ~w~ v~ted
wg~ h~t~.
~ li~ng fix~ due W fid~g / soffit ~1~. Nora: N~ Se~i~
~ Cabl~ ~1 ~ a s~ p~it.
New ci~t f~ ~ ~fio~ of MC ~ ~ i~i~l d~g~g ~tt ~o~e ~ ~
~di~d~ s~s ~ a duplex ~ ~ndomini~), ~1~ ~r~
ol~c~ oMl~.
The value of this work is $.~(~)O,C)(~I .
I hereby verity this woxk will be performed by an employee of this company and further verify
the reeonneetion / installation will be done in compliance with manufacturer mad Electric code
r~uitem~m, ~ '
(Signature of Company Of fi*er) ' (Print Nam e o f Officer) (Dale)