HomeMy WebLinkAbout0098804-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
1860 WISCONSIN ST
TENTH STREET STATION INC
Fuel ~J Gas
System [] New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
No
98804
L~J Forced Air
[~ectric
bJ Radiant
L~ Hot Water
Chimney Type ~ ChimneyA O Chimney B
Heat Loss ~ As Approved O Existing
BTU Rate ~.~ As Per Plan O Variable
Owner OUR SAVIOR EV LUTH CHURCH
Category 510 - Ind. & Comm-Heating & Ventilating
L~ Electric I L~ Solar
[] Replace I
~_J Steam I LI NC J
U Suppl. I L~ Con. Burner 1
O Direct Vent O Not Applicable I
~ Not Applicable I Value
~I Other I Value 125m btu
Create Date 11/25/2002
Plan
~J Solid
[] Other
L-J Vent
Use/Nature COMM/ CHURCH/ Replace furnace. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By: k~
$2,611.00 Plan Approval
$0.00 Permit Fee: Paid
[] Permit Voided
$45.50
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
ii/?/2oo2
28:39 9282368158
City of Oshkosh
Division of lnspcclion Services
P,O. Box 11130
Oshkosh, WI $4903-11 ~0
Phone (920) 236-5050
Fax (920) 236-5084
TENTHSTREETSTATION
HVAC PERMIT APPLICATION
All information after bold ¢.tegoric$ must be provided,
Incomplele applications will not be processed,
PAGE
, Application(s) and fcc(s) can bc bmusht to City Hall, Room 205 or marled to inspection Services.
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled
· normal p~rmlt fcc, which ever is greater.
OR
If y'¢~ are ,p contr~ng in the Permit fee/iccOunt $.¥sfem and has,¢ avleauote~'
if you wanS.this vrocess~d through your pccount [~] DATE / ]/'~ g/iff2-
ow~u__O~ s~'v,#~ Y bt41~-~ F,~-~ at'
CHECK 12I ALL A.PI'LICAI~LE
USE CATEGORY
U]$ingl¢ Family FIDuplex
ElMulti-Family EIRental , ~]Commercial Ullr.
IrlrEL I~[~as EYElcclri¢ ElSolid SYSTEM ElNew ~Replac
BOil EISolar FlOthcr
TYPE
~tForced Air i'lRadiant 13Steam FIA/C DVent ,ElEleetnc EJHol Water E]$uppl.
IS CHIMNEY BEING LII~TlgD l~l]lqo F1Yes - LINER. SIZE, & MANUFACTURER
Note: All chimneys shall bc sized per the BTU'$ being vented.
CHIMNEY TYPE rlChin-mzy A nchimney B
I~tDirect Vent EJOther
HEAT LOSS l'iAs Approved [~lExisting DNot Applicable
BTU RATE IElAs Per Plan FIVariable 1DOthcr Value /Z~
DESCRIPTION OF ALL WORK BEING DONE__. ~
VALUE (Including labor and #11 materials including light fixtures) $ 2~:~ ~[- fi0 ~ .' ~ ~ ~ ~
~For applicable project, an Elcc~c ~s~llation V~fication f~, si~ed by ~ ~cal Co~.
at. chad. If not a~ched or not appli~ble, a separate Elec~cal P~it is requi~d.
11/24/2002
28:39 9282368158
TENTHSTREETSTATION
PAGE
Electric lnstaiLttlon Verification
(J~lewi~ml ~n~tor ~e)
have ~en ~mr~t~ w perfo~ ~l~(dc i~taihti~ w~ foff~ ~
~nme ~f~y conUac~ed
(~ms wh~e work will bc
%c nature ofthe w~k co~s o~ (C~k ~e ~ ~c~bc ~c Ntu~ o(Wo~)
.~_ R~~n ~ flew ci~u~t ~r ~pl~t H~d~g Plmt ~or ~C
~ ~o~mhon or new c~t fro. r~le~t ~ie~ic Water Hc~er
wM~ h~t~.
~ Reco~mtlon of ~ S~i~ Entrn~ Cablc. Meter Box, el~a~o~ to reccptacl~
Efface Cabl~ will r~ a ~e p~it.
~ R~on ~ n~ ~,d for the ~l~t ofo~ p~tlM w~
appliques / fixture.
____ ~ ~i~uit ~ ~e ~ition of~C to m M~,,~ ~/;n~ u~, (~uae or the
iudiv~al s2~t~ns m a dup]~ or co~om~ni~mL inehai~ ~ui~ semite
ol~mical outlets,
Tho va]~ of~is wo~ is S_~~'~
I hgeby v~ this w~ will ~ p~ by n ~plo~o of~in ~m~y
r~ui~,
(-qiBneturc A£Compmjy Officer)
;.
~rint N.me o;Of~r)