HomeMy WebLinkAbout0105610-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 2549 FOND DU LAC RD
Contractor MARTENS HEATING & COOLING
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ARLINE R TOLLARD
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
105610
12/05/2003
Other
Vent J
Use/Nature CONDO/Replace furnace, 40m btu. *EIV form from Hoehne Electric.
of Work
Fees: Valuation
Issued By:
$2,200.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$38.00
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 PO BOX 106 WAUKAU WI 54980 - 106 Telephone Number
920-685-0111
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.
, Electric Installation Verification
(Electrical Contractor Name)
(Address) (City)
have been conLmcted to perform electric installation work for
at the following address:
(State) (zip~ C~a~)
of party contracted to)
(Address where wofl~ will be performed)
Thenature ofthe work consists o~. (Check One or Describe the Nature of Work)
~// Reconnection or new circuit 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 Service
Entrance Cables wilt require a separate permit.
Reconnecfion or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house ur the
individual systems ~n a duplex or condominium), hacluding required service
electrical outlets.
Other
The value of this work is $ /~/'~t~)' ~
I hereby verify this work will be performed by an employee of this company and further verify
the reconneetion / installation will be done in compliance with manufacturer and Electric code
requirements.
--~gnature of Company Officer)
(Print Name of Officer)
(Date)