HomeMy WebLinkAbout0099407-HVAC (furnace)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1834 ELMWOOD AVE Owner JAMES E/DANA A KOCH
Contractor TENTH STREET STATION INC Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas J ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m btu
No
Create Date
Plan
~J Solid
Vent
99407
01/09/2003
Use/Nature SFR/Replace furnace. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$2,179.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$38.00
Date 01/09/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 924 OHIO STREET OSHKOSH WI 54902 -0
Telephone Number
236-8770
01/08/2003 21:32 9202360150 TENTHSTREETSTATION PAGE 01
City of O~,~:k,
OivlsJon ~,(' h s.t:e "'on ,L;erviccs
P.O, Boa :;~}
Osi;kosh. 't'l 549 ) ;- t 130
Phone (920 ~
HVAC PERMIT APPLICATION
,,\II illl'ortllilliOll al'tcr bold categories must be provldcd.
· Apphca:~,m: :.'I and !~e(s) :an ,)e brought to City ]HAH, Room 205 or mailed to Inspection Servi..:cs. 1'(.' box 1128.
Os;qku.d' Wi 54903. i 12S. Commencing work without pe~i~(s) will result in fees 8ein~ doubic, d or S~00.00 plus the
nomx~ perm,; l'i~e, wJl{ch ever is gremer.
()R
FlCommcrcia} £ ln(,t:st: iai
FUEl. ~'J'G a. ~Electnc ~$oiid SYSTEM E3New
,'~(,)i! ~$olar IZ/Other
~Forced A i:' g h', idiam ~St¢~I~ ~A/'C OVent ~ Electric gltot Water ~Suppl.gCon. Burner
IS CHIMNEY 'lJglNG LIN};D ~No ~Yes - LINER SIZE & MANUFAC~RER
Note: All t'lq:'r:ll~t:2.~ shall bc xi?ed per ibc
CtlI:~51{V TYPE ~Chimnc) A ~Chimney 13 ~Direet Vent gOmer
}lEAl' I,OS$ [~.'~S Approvcd ~Exisling ~'Not Applicable
BT!~ t{ATE ~AS Per Pkm ~Varinhle UOther Value 7~
ELECTRIC'Al. *' ;ONTRACTOR__])~ ~ Olt' ~. EIccu'i,.- 1,:stagalio, Venncafi., form ami ,,t,;
01/08/2003 21:32 9202360150 TENTHSTREETSTATION PAGE 02
Electric Installation Verification
(Electrical Contractor Name)
(Address) (City) (State) (Zip Code)
have been contracted to perform eleclric installation work for.~'. ~'f/q ~ ~'-7~.~/,
Oqame of party contracted to)
(Address where work will be performed)
The nature~he work consists of: (Check One or Describe the Nature of Work)
~ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconneetion of the Service Entramge Cable, Meter Box, alterations to receptacles
and lighting fixtures duc to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Rcconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems J;l a duplex or condominium), including rcqmred service
electrical outlets.
Other
The value of this work is $ g;c% ~
I hereby verify this work will be performed by an employee of this company and further verify
the reeonnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
(Date)
5/02