HomeMy WebLinkAbout0102764-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 1044 JEFFERSON ST
Contractor RASMUSSEN'S HEATING & A/C INC
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 CHERYL A ROST
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O 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
102764
07/11/2003
Other
Vent J
2.5 ton
Use/Nature SFR/Install A/C. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$2,592.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$44.00
Date 07/11/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 5154 DAVID DR OSHKOSH WI 54904 -8850 Telephone Number
920-235-6569
P.O, B~c 11~0
Fax (9~0) ~-~4
HVAC PERMIT APPLICATION
All information ~ bold catt~o:i=s must b~ provided.
· Application(s) and fee(s) can be brought to City Hall Room 205 or mailed m Insp~ilon Strvic~s, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pmmit(s) will result in fees being doubled or $100.00 plus th~
normal permit fee, which ever is ~reater.
OR
If you are a Contractor particioatiu~ in the Permit fee Account System and have adequate funds, check here
if t~ou want this processed throu~rh your account [~
DA".I~ 7~10'o3
CH p:CK [] AT,I, APPLICABLE
USE CATEGORY
I~$ingle Family FIDnpl~x
E]Multi-Fnmily
13Rental [-[Comm 6i~ial EIIudustrial
~tr~L ~f~aas r~'lecUic FiSolid SYSr~ I~l~ew
r'lOil I-ISo]ar FiOther
FIReplace
TYPE
FiForced Air ~3T, adiant FISte~m ~C ~V~t ~c ~ot W~r ~S~pl.
~ C~Y B~:~ NG !.~ ~o ~ - ~ 8~ & ~A~
No~: ~ ~ s~sn ~ ~ ~'s ~ v~
I-ICon. Burner
DESCRIPTION OF ALI. WORK BEING DONE ~-~-~ ~/t-
VALU~(Ineludlnglabornndallnmt~mialsineludlngllght~.~eO$ o~ q~
Electric ~nstallation Verification
(Eleclrical Conlmolm- Nnme)
have been conlraoted to perform electric installation work for
at the following addr~:
(State) (Zip Code)
(Name ofpnn'y contracted to)
(Addre~ where work will be performed)
The n_n~ of the work consists oP. ( .Che~k One or Describe the Nature of Work)
__ ~ or ~ ~iwuit for replncement Hentlng Plant and/or A/C Condenser.
Recmmecl/on or new circu/t for rep~ent Electrio Water Henter or power vented
Reconnec/ion of the Service Entrance Cable, Meter Box, alterations to receptacles
and llghling fixtures due to lgdlng / soffit installation. Note: New Service
Entrance Cables will reqaire a sepan~te pemac
Reeonnecfion ornew circuit £or the replacement ofofl~ ~ wlred
New ~itcuit for the addition of A]C to an ~ d~elling ~mit 0louse or the
The value of fbi; work is $
I hereby verify this work will be performed by an employe~ ofthls company and further verify
the resonnection / insla!!ntioll will be done in ~mpllanoe with manufacturer and Electric code