HomeMy WebLinkAbout0102667-HVAC(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2767 CLOVER ST Owner THOMAS N RUSCH
Contractor AMERICAN HEATING & A C CO Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas J ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A O Chimney B ~ Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m btu
No
Create Date
Plan
~J Solid
Vent
102667
04/09/2003
Use/Nature NSFR/Install 75m btu furnace and air exchanger.
of Work
Fees: Valuation
Issued By:
$4,600.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$74.00
Date 07/07/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1129 MICHIGAN AVE OSHKOSH WI 54902 -6437 Telephone Number
(920) 235-8090
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 236-5084 JUL 0 ? 2005 oN
HVAC PERMIT ~PP~IION
All infomtion after bold ca~~~ Or
Incomplete apphcat,ons will not ~B~¢~EkOPMENT__
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to hspection S~ices, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pemit(s) will result in fees being doubled or $100.00 plus the
no~al pe~it fee, which ever is ~eater.
OR
I[ ~ou are a contractor participatin~ in the Permit fee Account System and have adequate funds, check here
if you want this processed throuTh your account
JOB ADDm;SS
CONTRACTOR
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
~t~dn gle Family V1Duplex V1Multi-Family
UlRental F1Commercial Fllndustrial
FUEL ~aSF1oil FISolarEIElectric F1Solid SYSTEM ~Oewther [2Replace
jFE
rced Air r-lRadiant FISteam [2A/C ~ent UlElectric [2Hot Water F1Suppl. FICon. Burner
IS CHIMNEY BEING LINED ~,1o EYes - L1NER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[2Chimney A
t-lAs Approved
U]As Per Plan
[~.,.himney B
F1Existing
[2Variable
F1Direct Vent [2Other
Applicable
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
OR U Electric Installation Verification form attached(If Replacement)
Etectr~cal installation of new/replacement equipment shall be done by licensed contractors,
3/02