HomeMy WebLinkAbout0105358-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 572 GRAND ST
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner DEBORA K SCHNEIDER
Category 500- Residential-Heating & Ventilating
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 O Existing ~ Not Applicable I Value
BTU Rate I~] As Per Plan ~] Variable ~ Other I Value
No
Create Date
Plan
~ Solid
105358
11/17/2003
Other ]
Vent
Use/Nature SFR/Install furnace & ductwork. *EIV form from Homeowner.
of Work
Fees: Valuation
Issued By:
$4,159.20 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$68.00
Date 11/17/2003
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 W8078 HILLCREST COURT HORTONVILLE WI 54944 -0 Telephone Number
(920) 779-8838
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.
Dt lslOll Of [tlspectlon Services
P.O. Box 1130
Oshkosh. WI 54903-1130
Phone (920) 236-5050 RECE
F'ax (920) 236-5084
HVAC PERMIT APPLICATIONNOV 1 7 2003
All information after bold categories must be provided.
incomplete applications will not be oroc~EPARTMENT OF
C)MM FY FVt 'MENTO UNIT D ELOP
Oshkosh WI 54903-1128. Commencing work w~thout permit(s) will result in l~es being doubled or $100.00 plus the
nomal permit t~e, which ever is greater.
OR
]/ )'ou are a c'(L~j2'~L~)r ~r~E.C~jl~/~.._(E_L~te Permit j~,e Account Sya'?_¢q._e~d b~2~e~/d~Lq.(U:t~qnds' check /t~,re
~2:.(4]t ~fl( t/lis processed through Four account
- 0
CHECK [] ALL APPLICABLE
l. SE CATEGORY
l~ngle Family E]Duplex
[~ Multi-Family 12Rental
I-ICommercial
[] Industrial
FUEL l~'as l~lElectric [Solid SYSTEM ~ew [2Replace
[]Oil []Solar .~]Other ....................
TYPF,
~'~)rccd Air []Radiant [Steam F1A/C E]Vent 71Electric E3Hot Water E]Suppl. OCon. Burner
IS CHIMNEY BEING LINED ~o ~Yes - LINER SIZE
Note: All chimneys shall be sized per thc BTU"s being vented.
& MANUFACTURER ..............
ClilMNEY TYPE
HEA'F LOSS
BTU RATE
OChimney A
UIAs Approved
~As Per Plan
DChimney B [Direct Vent ll;kOlther ~)~K2
~xisting UNot Applicable
12]Variable [~-)ther Value t~$'aO Ze$¢__F~__g~ ....
DESCRIPTION OF ALL WORK BEING I)ONE_._~~.,.~...._0~-~
VALUE (h,duding lahor and all ma(erials including light fixtures) $..~.~_~,0~ 9.0
,LEC 1RICAL CONTRACTOR ................ O_~R [ I Electric Installation Verification form attaeheddf F, cptaccmcnt)
3/02
City of Osl~sh
Division of Inspe~ion Service~
Oshkosh WI 54903-1130
Electric Installation Verification
the homeowner(s) of ,~ ? 0.
(print homeowner(s) name)
(address where work is to be performed)
ccept the responslblhty for performing the electrical work as stated below for the property hsted
above.
The nature of the work consists of: (Check One or Describe the Nature of Work)
___..~ Reeonnection or--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 Servic~
ntrance Cables v~ll require a separate permit.
Reconnecfion or new circuit for the replacement of other permanently wired
appliances / fixtures.
__ New circuit for the addition of MC to an individual dwelling unit, including
required service electrical outlets. Note: Homeowner, can only do their own
electric on a ~ingle family owner occupied home. Work on a condominium,
duplex, rental, or multi-use building would require a licensed master
electrician.
Other
The value ofthis work is $. 0/O'' ~ o
I hereby verify this work will be performed by me and further verify the reconnection /
installation will be donein compliance' w~th' manufacturer and Electric code requirements..
Homeowner(s) Signature
(l~ate)
5/02