HomeMy WebLinkAbout0098457-HVAC (furnace; duct) CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 239 W 11TH AVE Owner CLEM STROMSKE
Contractor TENTH STREET STATION INC Category 500- Residential-Heating & Ventilating
Fuel [] Gas I [] Oil I ~ Electric I ~ Solar
System [] New I [] Replace
~J Forced Air I ~ Radiant J L--J steam J L~ NC
[] Electric 1 [] Hot Water 1 [] Suppl. 1 E~-Con. Burner
Chimney Type ~ Chimney A ~ Chimney B I~1 Direct Vent ~ Not Applicable
Heat Loss ~) As Approved O Existing ~ Not Applicable I Value
BTU Rate ~ As Per Plan ~ Variable O Other I Value 75m btu
No 98457
Create Date 11/06/2002
Plan
bJ Solid
[] Other
Vent
Use/Nature SFPJ Replace 2 space heaters with forced air furnace & duct system. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$3,800.00 Plan ApproVal $0.00 Permit Fee Paid
[] Permit Voided
$62.00
Date 11/06/2002
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
236-877O
City of
Dixision of ]nspc¢6on Services
P,O. Box 1130
O~l'.kosb, WI 54903-1130
Phone (920) 236-5050
F~ (920) 236-5084
HVAC PERMIT APPLICATION
All infonration after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fcc(s) cnn be brought to City Hall, Room 205 or mailed to Inspection Services, PO 13
Oshkosh WI 54903-1128. Comn~ncing work without permit(s) will result ia fees lacing doubled or $163.
normal permit fee, which ever is greater.
OR
Iffy'Gu are t~ conr,,,ra~tor particioatine in the Permit fee Ac¢oun_t_$v~tem and have adeauate funds, c
if_yOu want this proc'erred throu.eit vour accoutlt ~_
D^ z
JoB .vm~tss, z 3q W' ! t. ~ Av~, ,
.: the
CHECK [] ALL APPLICABLE
USE CATEGORY
~ingle Family r'lDuplvx
ClMulfi-Faraily i-IRental
E]Commcrcial
I-Ilndustri:',:
FUEL {:~as EIEle¢~e raSolid SYSl,EM ~New ~ ClR~plaee
E]Oil DSolar [3Other
l~'~rced Air EiRadiant ElSteam EIA/C ElVent CIEleetnc EIHot Water ['lSuppl. EICon.
IS CHIMNEY BEING LllCED I~_o_ EI,,Y,¢s - LINER SIZE
· Note: All chimneys shall be sized per the BTU s bein~ ventexi.
. & MANUFAC~ ......
CHIMNEY TYI~E r'lchirrmey A r'lChimney B I~Direct Vclat
I-lEAl' LOSS CIAs Approved I~xisting ClNot Applicable
x zscaumo A LWO X z
VALUE (Including labor and sill materials including light fixtures) $ 3 ~00., ,.to,
EL~Crmc~. CO~CrRACl,O~ a~e ~-
Elt~or applicable projects, an Electric Installation Verification fon~ signed by the Electrical
attached. If not attached or not applicable, a separate Eleotrical Permit is rvquired,
C/%'°°
Electric Installation Verification
(Ele~irlcal Contrnctor Name)
(Address) (City)
have been cm~tracted to perform electric installation work
at the following address: _.~ ~
The nature of thc work consists of~
(State) (Zip Code)
(Name ofpm't~ contracted to)
g-
(Address where work will be performed)
(Check One or Describe the Nature ef Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser,
Reconnection or new circuit for replac~nent Electric Water Heater or power vented
water heater.
R~connection of thc Service Enlrnnce Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliance~ / fixtures. ,
New circuit for thc addition of-j*o*L=qo an i~3~t~d~a/~/P, ng ~/~ (house or ~he
~dividual syst~s in a duplex or condon~nium), includin8 required aerYjc¢
electrical outlets.
The value ofthis work is $
I hereby verify tiffs work will be performed by an employee ofthis company and fiirther verify
the reconnection / installation will bc done in compliance with manufacturer and Electric code
requirements.
c0mpany O fi cr)
(Pr/hr Name of Officer)
(Date)
5/02