HomeMy WebLinkAbout0102641-HVAC (a/c's)(~ CITY OF OSHKOSH No
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 985 987 ALPINE CT Owner JEFFREY M GROFF
Contractor AMERICAN HEATING & A C CO Category 501 - Residential-Air Conditioning
Fuel ~J Gas ~ ~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 ~ Chimney B O 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 two 24m A/C
Create Date
Plan
~J Solid
Vent
102641
07/03/2003
Use/Nature DUPLEX/Install two 2-ton central A/Cs. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,800.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$47.00
Date 07/03/2003
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54-903-I 130
Phone (920) 236-5050
Fax (920) 236-5084
RECE VE
JUL O 2 200j
HVAC PERMIT APPLICATION
MI m~o~atio~ a~¢~ bold categories must be provided.
Zncomplet¢ applications will ~ot be processed,
e Application(s) and fee(s) can be brought to CiW Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
lf vou are a contractor participatiltg in the Permit fee Account System and have adequate funds, check here
if you want this processed iht'ouch your accottn!
DATE
ADDRE S 3'd - qg 7 _
OWNE.
CONTRACTOR ~~
CHECK [] ALL APPLICABLE
USE CATEGORY
F1Single Family [~uplex
I-1Multi-Family IDRental
[3Commercial
F]Industfial
FUEL [~as E]Electric F1Solid SYSTEM ',J~f~tew FIReplace
[2]Oil FlSolar FiOther
TYPE
[2]Forced Air F1Radiant F1Steam'I~/C [3Vent IZlEIectric F'lHot Water
V1Suppl. FICon.
Burner
IS CHIMNEY BEING LINED~,I~o I'-Iyes - LINER SIZE
& MANUFACTURER
Note: All chinmeys shall be sized per the 13Tl. J's being vented.
CHIMNEY TYPE FIChimney A l"lChimney B ~rect Vent FtOther
HEAT LOSS F-las Approved FIExisting ~':got Applicable
BTU RATE FIAs Per Plan UlVariable ~i~ther Value ~,~
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ 2~-~frO/-) ~
XElectric Installation Verification form attached(If Replacement)
ELECTRICAL
CONTRACTOR
OR
ElectHcal installation of new~replacement equipment shall be done by licensed contractors.
3/02
CJI-/of O*~qkosh
Electric Installation Verification
(El~c~ ~n~tor N~e)
(Ad~) (City) (State) (Zip Code)
have been con~act~ to peffom electhe installation wo~ for ~
~thefollowingad~ess: .~?~ ¢7 ~1~*
(Ad~e~ where w~rk will ~ peffo~)
The nature of the work consists off (Cheek One or Describe the Nature of Work)
~ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
__ Reconnecfion ornew 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 Service
Entrance Cables will require a separate permit.
~ Reconnection or new cimuit for the 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 $
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
requirements.
(Print Name of Officer)
(Date)
5,102