HomeMy WebLinkAbout0105908-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 2495 PARKSIDE DR
Contractor BLACK-HAAK HEATING
Fuel
System
Gas J ~J Oil
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner SHARON KINDERMAN
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B O Direct Vent ~) Not Applicable I
O Existing ~) Not Applicable I Value
~ Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
105908
12/31/2003
Other
Vent J
75,000
Use/Nature
of Work
Replace gas furnace. * EIV form from Krueger Electric.
Fees: Valuation
Issued By:
$3,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$50.00
Date 12/31/2003
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 3070 APPLETON WI 54914 -70 Telephone Number
920-757-9990
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
(&x!~trical Con~'actor Name)
(Address) (Ci~)~ (SI~ (Zip Code)
/Ad~s wh~ wo~ ~U be
~e aa~ ofthe work con~ of: (~eck ~e or D~dbe ~c Na~ of Work)
. )~ Re'connection or new circuit for replacement HeaTing Plmat md/or .~dC Condenser~
,, Recormeedon or new ci~:uit for replacement El~'ic Water Heater.
_ Reeonnection of the Serwice Enlranee Cable, Me~e~ Box. alterations to receptacle.~ and
~- light/ag fixtlm~ ~uo to siding / mt'fit installation. Note: New Service £ntl'aneo '
Cabim will require a separate pein'fit.
..... Re¢ormeetion or new tumult tbr other p~u,a-mently.wS~ ~pliane~ / fixtures.
Other
The vahm of this work is $
/Sc)
hereby verify this work wilt be ~-rformed by an employee of thiS ¢o~ipa~y and further ver~ fy the
reconnection / installation wall be done in compliance with manufacturer and t~leetric code
requiremenB.
(Sim'~amre of C mo ~my Officer)
(Print Name of 0fficer~
(Date)