HomeMy WebLinkAbout0098805-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
2045 HICKORY LN
TENTH STREET STATION INC
Gas I
[] New
L~J Forced Air J
~J Electdc
Chimney Type ~ ChimneyA
Heat Loss ~.~ As Approved
BTU Rate ~,~ As Per Plan
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner AHMAD Y/LINAH R HAFFAR
Category 500 - Residential-Heating & Ventilating
Oil j LJ Electric t U Solar
[] Replace J
bJ Radiant
~ Hot Water
Chimney B
O Existing
d.~ Variable
[__J Steam I bJ Nc I
~-~uppl. 1 ~ Con. Burner I
Direct Vent ~ Not Applicable
~_~ Not Applicable J Value
~ Other J Value
No 98805
Create Date 11/26/2002
Plan
J J~ Solid
[] Other
~ Vent
125m btu
Use/Nature
of Work
FPJ Replace furnace. *EIV form from Drexler Electric.
Fees: Valuation
Issued By: K~
$2,500.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$42.50
Date 11/26/2002
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
236-8770
1~/25/2002 21:i6 9202360150 TENTHSTREETSTATION PAGE 01
City of Oshkosh
Division of Inspcc6on Services
P,O. Box 1130
OshkoSh, WI .54903., 1130
Phone (920) 236-5050
Fax ¢920) 236-508,1
HVAC PERMIT APPLICATION
Al} ioformafion after bold categories must be provided.
Incomplele applicatiOf~S will not be processed.
Application(s) and fee(s) can b~ brought to City Hall, Room 205 or mailed to Inspection Services
Oshkosh WI $4903-I 128, Commencing work without permit(s) will result in fees being doubl~','
normal permit fee, which ever is greater.
OR
[f you are a ccntractor ~arttcjl~atinff in thc Permit fee ~ccount System__l!nd.. haue adeouate '
if ~ou want tt, i.~ p,'oce.~'~ed t~rouzh your a~
DATE~~~
CHECK [~ ALI. APPLICABLE
USE CATEGORY
[~lf, Single Family r-iDuplex
nMulti-Family [3Rental VICommercial O1"
FUEL l~Gas ElElectric EJSolid SYSTEM ElNew ~gRepl:'~
E]Oil E]Solar ~Other
TYP£
I~[~Forced Air FIRadiant ~Steam nA/C [~Vem ClElectric VIHot Water 12Su,i~pl. U'
IS CHIMNEY BEING I,INED [~No OYes - LINER SIZE
Note: .All chimneys skall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE UChjrrmey A ElCllimney B I~Direct V~nt nOtber
HEAr LOSS F_.3As Approved O~ixisting ,'-INot ApPlicabie
BTU RATE [Y'JAs P~r Plan nvariable [~fOther Value_ I'Z~'_/~__~'~/~.~_ _
DESCRIPTION (')g ALL WORK BEING DONE
ELECTRICAL CONTIL4,CTOR
~%r applicable prOJects, an Electric Installation Ver/fication form, signed by the Electrical ("~.
attached. If not attached or not applicable, a separate Electrical Permit is required.
1~/25/2002 21:16 9202360150 TENTHSTREETSTATION PAGE 02
Electric Installation Verification
(Elcctrlcal Contractor N~o)
I ~-- RCCOnu~tion or n~ circni( for r~l~em~t Hcati~ Pi~T ml~or ~C Co~.
.~ R~o]m~jon or new circuit for r~l~ent
~d 14~ting fixatr~s duc to ~di~ /
~c Cabl~ will require a ~te ~t.
~_ Rc~lmcclion ~ a~ c.cuil for t~ ~bcement of ot~ P~gnlly wi~
appJi~om /
individ~l s~t~s in a duplex ~
el~ca~ outlets.
~ Oth~
l hereby verify this work will be per£ot~ed by' Mi m~ployee of mi~ compMiy and further vmty
the re~ormection / lnm~ltat~on will be done in complimi~e with manufacturm, and l~lectric oode
($18nattm of CompMiy
(Print Nm'ne o£Offic'er) (D.te) -"--"'