HomeMy WebLinkAbout0105362-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 1406 WESTERN ST
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner SUZETTE A THIBADEAU
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
105362
11/17/2003
Other ]
Vent
Use/Nature SFR/Install furnace & ductwork. *EIV form from Bell Electric.
of Work
Fees: Valuation
Issued By:
$3,600.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$59.00
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.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903~ I 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION IVo[/ 7 ?
All information after bold categories must be provided. 200~
Incomplete applications will not be processed D~D,~
Box ll
28,
Oshkosh WI 54903~1128. Commencing work without permit(s) Will result in tkes'~" ~'~"'being~d~dt~dk[~O.(10 plus the
normal permit fee, which ever is greater.
OR
/[ you are a c(L!!j_rar__Jgt~' ~tL.(~_2(!?~t_Q!g in the Permit [~(e Account S¥,~tem...qdJ~_l~h_a~?__q.(l_e_qt~qt__e [~nds check here
i~A,.q_.lt want this processed through your account ~
JOB ADDRESS
DATE
CItECK [] ALL APPLICABLE
USE CATEGORY
~:;l'S~i'n gle F,'unily [3Duplex F'lMulti-Family
ZlRcntal IDCommercial Zllndustrial
FUEl, ~as FlEtectric []Solid SYSTEM FlNew ~Rcplace
Ci()il FlSolar FlOther ....................
~E
rced Air CiRadiant [3Steam CIA/(? EJVent CIElectric F1Hot Water CISuppLE3Con. Burner
IS CHIMNEY BEING LINED F1No I-lYes - LINER SIZE .........
Note: All chimneys shall be sized per thc BTU's being vented.
ClilMNEY TYPE
HEAT LOSS
BTU RATE
FlChimney A
UlAs Approved
ZlAs Per Plan
[21Chimney B
.[ .~isting
UIVariable
& MANUFACTURER ...............
ElDirect Vent ~ther ~i~(,..
~Not Applicable
DESCRIPTION OF ALL WORK BEING I)ONE___~.._.__-~/.d. LJEk~x~ ~'~~'~..._~'~
VALUE (Including labor and all materials inclnding light lixtures) $_...~_.t&l~.0/;' ~ 6'
ELECTRICAL CONTRACTOR_~_~t( __~_/.~t*,t'J]_t_ OR il Electric Installation Verification form
Electric Installation Verification
1 (we)
(Electrical Contractor Name)
(Address) (City) (State)
have been contracted to perform electric installation work for ~z~/ ' or, '
r/~ ,~ ~/5/(
(Name of party contracted to)
(Zip Code)
atthefollowingaddress: _~q~eT ~J'tl3~ e~cI /~Pt~ I~e.~~n'r'v .5. T d~.~'/?
(Address where work will be performed) ,:/.~, t/,. 0/0 $
The nature ~work consists off (Check One or Describe the Nature of Work)
_/~_ Reconnection or new circuit for replacement HeafingPlantand/orA/CCondenser.
~ Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
..... Reconnection of the Service Entrance Cable, Meter Box, altemtious to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
_ Reeonnection or new circuit for ttle 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 $
1 hereby verify this work will be performed by an employee of this company and further verify
thc reconnectima / installation will be done in compliance with manufacturer and Electric code
requirements.
(Signature' of Company Officer)
~ h-~cY'-e.,~
(Print Name of Officer)
(Date)
5/02