HomeMy WebLinkAbout2003-HVAC (furnace-a/c)OSHKOSH
ON THE WATER
.lob Address 1409 W 2ND AVE
Contractor A-1 HEATING & A/C INC
Fuel
System
Gas J ~J Oil
New ~
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner EUGENEIARNOLDUSSEN
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss IO As Approved ~ Existing
BTU Rate IO As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102820
07/09/2003
Other
Vent J
Use/Nature SFR/Replace furnace and A/C. * Job #1488. EIV form from Mr Teas.
of Work
Fees: Valuation
Issued By:
$3,300.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$54.50
Date 07/14/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W8078 HILLCREST COURT HORTONVILLE WI 54944 -0
Telephone Number
(920) 779-8838
HVAC PERMIT APPLICATION
AlI illtbttBatioll af'tcr bold categories m~mt be plovjdcd.
Incomp[c[c app]Jcatmns will md bc processed,
Applscahon(~) and I;ec(s) can bc brought to (:ily I lall, Room 205 ()~ madcd to Inspectkm Scl'vices, I)() Box 1128,
Oshkosh W[ . 4903-112~. Commencing work w)thmit pemm(s) will rt:sult m t~cs bcmg dmibJed oT $~O0.0O plus the
normal permit [i~e, which ever is greater.
OR
CIIIqCK [] Al,I, AI'PI,I¢TAIII,E
ilillSinglc Family IZIl)uplcx gMulli-Family IDRcutal F~{:'ommcrc d E]lndustrial
I;I !F,I. JltlSas I-IEiccmc Ul.qolid SYSTEM
UNcw
JRcplacc
UIoit ~So}ar LTlOther
*I'YPE
lllII;olccd Air lZIRadumt U]Steam I~AA.' [7.1Vcnl [31ilcctric [2ttot Walm I~Suppl,IZlCon~ IJiulltcr
IS (!!IIMNEY BEING I,INI,;I) l~No E]Yca - LINER SIZE
Note: AlI chimneys sl'ulJl be sized pet the BH ~'s I)enlL~ vtmled
('tIIMN};Y TYPE
I I EAT IA)SS
BTll RATIO;
IZlf 'hin'mey A
I~As Approw:d
t~lAs Per Plan
& MANUI;A( q'URiLR .....
IZl('hmmcy H
LTIlixisttng
[3Variable
I~l hrccl Vcn! I-If )thcr
Applicable
I,J( )tt~c r Value
Electric Installation Verification
r (t';lcctrical Contractor Namc)
Address) (('ily) ~State) (Zip Code)
(Namt~ of party contraclcd to)
Address ~vherc work will bc perfi)rmcd)
Thc nature of thc work ccmsists of': ((.' hock Onc o~ Describe Iht Nature of Work)
~on or n.w c,rcuil lbr replacement H~,~.t at,(t/~, C(
_ Rccommctlo~ ot new circuit tbr replacement L~lectric Waler l loafer or power vented
water heater.
........Rccom~ection of the Scr ~cc [,ntt, race Cablu, Meter Box, a}tcmtions lo receptacles
~CI'VICC
mid lighth~g fixlurcs t uc o sidi~g/soffit inslallalion. Nolo: New ' · '
l;,~tnmce ('ablcs will ~cquirc a separate permit.
......Rccommclior~ or new circuil ~br thc rcplaccmenl of other pcmmncnl}y wired
appliances / fixlur~s.
· (
...... New circuit [bt lhc add o '~ of A/, t:o an imhvidual dwelling um't (house or the
individual systems m a duplex or comkmmfium), h'mludJng rcquh-cd service
electrical oullcts.
Other
Thc value ol' flus work is $ ................. .
I hereby verily this work will bc pcribrmed by an employee of this cornpany and fi~rthcr verit~
thc, recotlucctJorl / installation will bc done in compliancc with manuthclurcr and Electric c(~tc
r(zquirclltellts.
(S gnaturc ol Company Officer) (t:'rml Name of ()filter)
(l)atc)