HomeMy WebLinkAbout0105629 HOSHKOSH
ON THE WATER
.lob Address 202 W MELVIN AVE
Contractor
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
THOMPSON HEATING AND COOLING SI
Oil
Owner MARK D SACHARSKI
Category 500- Residential-Heating & Ventilating
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
105629
12/05/2003
Other
Vent J
Use/Nature SFR/Replace furnace. *EIV form from T Puck Electric.
of Work
Fees: Valuation
Issued By:
$1,700.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$30.50
Date 12/05/2003
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.
O/HKO/Im
Electric Installation Verification
(Electrical Contractor Name'}
tAddress) (City/ (State) / (Zip Code)
have been contractett to perform electric installation work for ~--~z,~
(Name of parry contracted to~
at the follo~ving address: ~c2~.~ ff~,
(Address where work will be performed)
The nat. ute of the work consists of: (Check One or Describe the Nature of Work)
~ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Recormection or new circuit tbr replacement Electric Water Heater or power vented
water heater:
Reconnection o£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 for the rep!acement 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 $ /~t~, d29
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
req~}r~ f'nents.
,/($~g~ ~tdr4 ofComp"Fa'~y O~cer) '(Print' Nhme of Officer) ' / (D/at~)-
5/02