HomeMy WebLinkAbout0098458-HVAC(~ ' '* CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 742 VINE AVE Owner AMBER J LETT
Contractor TENTH STREET STATION INC Category 502 - Residential-Both
Fuel ~J Gas I L~ Oil I ~j Electric L~ Solar I ~-~d
System [] New I [] Replace I [] Other
L~J Forced Air I ~ Radiant I L--J Steam L~ NC I
[~ Electric t U Hot Water I ~ Suppl. ~ Con. Bumer I
Chimney Type O Chimney A (..~ Chimney B O Direct Vent ~.~ Not Applicable I
Heat Loss ~ As Approved I~ Existing ~,~ Not Applicable I Value 0
BTU Rate ~ As Per Plan O Variable ~11 Other I Value 50m btu & 2 ton a/c
No 98458
Create Date 11/06/2002
Plan
Vent
Use/Nature
of Work
IFR/
Replace furnace & add new a/c. *EIV form from Drexler Electric.
Fees: Valuation $3,312.28 Plan Approval $0.00 Permit Fee Paid $56.00
Issued By: Date 11/06/2002
[] Permit Voided
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
Ci~ of'Oshkosh
Division of Impcction Services
P.O. Box 11)0
O~kosh, Wl $4903-1130
Phone (920} 236.$050
Fmx (920) 236-5084
HVAC PERMIT APPLICATION
All information at'let bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can I~ brought to City Hail, Room 205 or mailed to Inspection Services, PO'
Oshkosh WI 54903-1128. Commencit~g work without permit(s) will result in fe~s being doubled or $ l.
normal permit fee, which ever is ~reater.
OR
l£vo~ ore o contractor ~artictoattn£_.in the Pgrmt~ fee ~4ccount System and haut hdeouate l'u.n~t"
if_you want..~h~s p roc~s~-ed t~r~ueh, .... YOur af,.~ount.. ~ ....
, .l ,1o =
CHECK I~ ALL APPLICABLE
USE CATEGORY
I~ingle Family I-IDuplex
DMulti-Family t-IR~ntal OCommercial rUlndus:
FUEL ll[IGas I~]~,lcctrlc li3Solid SYSTEM
I"lOil ClSolar
TYPE
I~Forced Air [;]Radiant i'lSteam ClA/C r'lVent ~)F, lectric
IS CHIMI~Y BEING LINED [~[No EIYes - LINER SIZE.
Note: All chimneys shah be sized per te BTU's being vented.
~Hot Water I'lSuppl. [::ICon. '
& MA/qUFACTUP. I~
CEIMb'EY TYPE r=lChirrmcy A I"lChinmcy B 15~Direct Vent I-IOther
HEAT LOSS r'lAs Approved ~:Existing r=tNot Applicable
BTURATE I::]AsPerPian ~Variable l~OtherValue _~_~:t,'~ /~4//~
VALUE (Including labor and all materinls Including IJlht fixtures) $3
~ For applicable ~oj~, an Elcc~c ~stallation Ve~fiCation fo~ si~ed by ~e ~ec~cal Con~;, .
a~ched. If not a~ched or not applicable, a s~atc Elcc~c~ P~t is ~ed.
PAGE OG
I (We)
Electric Installation Verification
x/-.. lC_
(Electrical Contractor Name)
(Address) (City)
have been contracted to perform electric installation work for
(State) (Zip Code)
(Name of party contracted m)
(Address where work will be performed)
The nature of the Work consists of: (Check One or Describe the Nature ofWork)
~ 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.
_ Rcconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
ami lighting fixtures due to aidin~ / soffit instalhtion. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
. ~ New ch'cult for the addition of A/C to an indivtdualdw~lling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
~ Other
The value of this work is $ / ~t!). O0
I hereby verify this work will be performed by an employcc of this company and further verify
the reconncction / installation will be done in compliancc with manufacturer and Electric codc
requirements,
(Signature ~f Company Officer)
(Pdnt Name of Officer)