HomeMy WebLinkAbout0102838 HOSHKOSH
ON THE WATER
.lob Address 517 ALGOMA BLVD
Contractor TENTH STREET STATION 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 JOHN T/LINDA PORIOR
Category 501 - Residential-Air Conditioning
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
102838
07/07/2003
Other
Vent J
3 ton
Use/Nature SFR/Replace 3 ton A/C. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$1,100.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$21.50
Date 07/15/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 924 OHIO STREET OSHKOSH WI 54902 -0
Telephone Number
236-8770
FROM :TENTH STREET STATION, INC. FAX NO. :920-2~G-0150 Jul. 07 2003 10:lOAM P5
City of Oshkosh '
Division of Impection ~rvic~s
P.O. Box 1130
Oshkosh, WI $4905-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All informatio,~ after bold categories must be provided.
Incomplete applications will not beprocessed.
~ Application(s) and f~(s) can b~ brought m City Hall, Room 205 or mailed to Inspection Services, PO Box 112g,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal pernllt fee, which ever is greater.
OR
~m d ha~e hd uat unds. check re
ou a t this rocessed thro h our acco n
-
CH~CK IBI ALL APPLICABLE
USE CATEGORY
UICommcrcial IDIndustrial
FUEL' ElGas '~J~leatfi¢ r'lSolid SYSTEM
r'1Oil , I-ISolar
TYPE
OForced Air EIRadiant rlS~eam I~JC Clv~nt ElElectfic
IS CB][M~rEy BEING LINF, D ~Io I-lyes . LINER SIZE
Note: All chinmeys shall be sized per the BTU's being vented.
CHIMNEY TYPE l-IChinmey A EIChimney B ,._~D_irect Vent ~Othcr
IIEAT LOSS I-lAs Approved I~Existing 'l~Not Applicable
BTU RATE EIAs Per Plan /2Variable I~Other Value
FINew I~lace
OOt~
rqHot Water E1Suppl. EICon. Burner
_ & MANUFA~R
~ALUE (Including labor and all materials including light fixtures) $~/~/9. ~
~ For applicable projeols, an Elcc~c Installation Verification form, sig~ed by thc 1
attached. If not attached or not applicable, a separate Electrical Perrnit is required.
FR~ :TENTH STREET STATI~,INC.
FAX NO. :~0-~36-0150 Jul. 07 2003 10:llAM ~6
.. . Electric Installation Verification .. :' . . .
(Electrical Contractor Name)
'' . : - (Ad&e~) ~ ' (City) (Slate) (Zip
': ~ ' ~e of pray contract~
. . ~e namm of~e work co~i~ of (~k One or Describe ~e Nat~e of Work) '
~' ~mo~echon or n~ circuit for r~lacmmt H,a~g p~t ~or MC. Condmser
~ R~o~o~ or n~ cimmt for replacment Electric Wa~ Heaer or pow~ vent~
~o~on of.~o $e~ce Entr~ce Cable~ Meter Box, ~tcmfiom to receptacl~
~d li~g ~es due to sidhig / soffit ~*mllafion. Note; New Semite
R~o~ecfion or n~ cim~t for the ~lacem~t ofo~ Pe~enOy
' . . ~vid~l s~ms ~ a duple~ 0r cond°mi~m)' ~cludi~ reqtfired semite
' elec~ic~ outlet.
' "'I h~eby vefify~this wm~ ~I1 be poffo~m~ by ~ mployee of~i, eompmy ~d ~hm- v~fy
, ' · ~e r~micction / ~Iafion ~11 be done ~ compli~ce ~ ~ufacmr~ ~d Blee~c c~e
( ~ reofComp~yOfficor)
(lhSnt Nam; of Officer) (Date) : .
5/02