HomeMy WebLinkAbout0102723-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 447 W 10TH AVE
Contractor AMERICAN HEATING & A C CO
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MICHAEL C/AMY J REINHARDT
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 O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102723
07/09/2003
Other
Vent J
100m btu
Use/Nature SFR/Replace gas furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$1,700.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$30.50
Date 07/09/2003
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 ~sh~osh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
,JUl_ 0 9 zooJD_fHKO, fH
HVAC PERMIT
OF
All information after bold categories mu~f'Btq~'~l~qgEl/r~
Incomplete applications will not be processeo.
Application(s) and fee(s) can be brought to City ttall, 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 participating, in the Permit fee Account System and have adequate funds, check here
if you want this processed through vour account [~
CHECK [] ALL APPLICABLE
USE CATEGORY
~[~ingle Family I-1Duplex
V1Multi-Family VIRental
V1Commercial
~Industrial
FUEL _)~-Ga s I-IElectric I~Solid SYSTEM F1New ~.eplace
Ii]Oil ESolar EOther
PE
orced Air F1Radiant ESteam EA/C EVent EElectric EHot Water ESuppl. ECon. Burner
IS CHIMNEY BEING LINED ENo ~fes - LINER SIZE ~" & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEATLOSS
BTU RATE
I"lChimney A V1Chimney B F1Direct Vent l~ther
r-lAs Approved l~isting ENot Applicable
mAs Per Plan IDVariable .l~t~her Value
DESCRIPTION OF ALL WORK BEING DONE ;~zg/~E~ ~2d"
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR
Electrical installation of newtreplacement equipment shall be done by licensed contractors.
3/02
Electric InstaLlation Verification
(~l~al ~aclo~ N~)
(Ad.ss) (City) (State) (Zip C~e)
ha*e ~en con~ael~ to perfo~ el~ric insmlla~on work for ~ ~ ~ ~ ,
at ~e following ad~s: ~,
(Ad.ess whe~ work will be peffom~)
The nature of the work consists of: (Cheek One or Der~dbe the Nature of Work)
Reeonnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reeonneetion or new circuit for replacement Electric Water Heater or power vented
water heater.
Recormection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation, Note: New Servlee
Entrance Cables will require a separate permit.
Reeormeetion or new circuit for the replacement of other permanently wired
epplianees / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual sy~ter~s 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 reconneetion / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
(Date)
5/O2