HomeMy WebLinkAbout0099182-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
838 BOWEN ST
TENTH STREET STATION INC
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
~J Gas I ~ O, I
[] New
Forced Air j
Electdc J
Radiant
Hot Water
Chimney Type ~ Chimney A (.~ Chimney B
Heat Loss ~ As Approved ~1 Existing
BTU Rate ~ As Per Plan ~ Vadable
Owner RICHARD E PAGEL LIVING TRUST
Category 502 - Residential-Both
Ed Electric j ~J Solar
[] Replace J
L--J Steam J L~J A/C
J~ Suppl. J J~ Con. Burner
Direct Vent (...) Not Applicable j
Not Applicable t Value
Other I Value
No 99182
Create Date 12/26/2002
Plan
~1 Solid
[] Other
I-J Vent
0
80m btu heat & 2 ton a/c
Use/Nature SFR/Replace furnace and a/c. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$4,600.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$74.00
Date 12/26/2002
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
~2/19/2002 84:56 9282368158 TENTHSTREETSTATION PAGE 01
CiD, of Oshkosh
Division of Inspection Services
P.O. ~x 1130
Om~h, ~ 54~-1130
P~ne (~20) 236-50~0
Pax (920)
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete spplicatiom will not be proce~ed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) w~ll result in fees bcmg doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
l£ vou are, a contractor l~articit~atine in the Permit. [g~e Account SvsHg~n and have &deauate fundx, check here
[~-vou want tats pro{;¢s~efl throueh ~,vur a¢C-ount _~ - -
DATE,/~.c_//~ ~-
Jo, UOaESS 1555
CHI~.CK [] ALL APPLICABLE
USE CATEGORY
5l~gingle Family EIDuplex
rqMulti-Family C3Rcntal ClCommcrcial CIIndustria]
FUEL ~3as E]Electric ElSolid SYSTEM FINew [iiReplace
EIOii 13Solar mOther
TYPE
~Forced Air ~Radiant FISteam ~A/C ~Vent ~Eleetric C]Hot Water ClSuppl. DCon. Burner
IS CHIMI~Y BEING LINED I~No FIYes - LINER SIZE & MANLIFA~
Note: All chimneys shall be sized per ti~ BTU's being vented. ~ O~'yA&, g4 ~
CHIMNEY TYPE r'lChimney A ClChimney B I~Direet Vent 12Otber
HEAT LOSS C]As Approved ~Existmg nNot Applicable
BTU RATE CIAs Per Plan F1Vanable I-IOther Value g~.~rl9 ~:~)t~t/~ ~
DESCRII~][~ON OF ALL WORK BEING DONE
---- -
VA_LILlE 0n¢ludiu{~ labor and all matmals including light fixtures) $
ElXC ' UCA cos c o D, WX
~For applicable pmjecm, an Elec~c ~stallation V~fica~ f~, si~ed by ~e Elec~cal Con~ctor, must
a~ched. If not a~ched ~ not applicable, a ~aie Elecmcnl P~t is ~.
~' j~/19/2002 84:56 9202368158 TENTHSTREETSTATION PAGE 02
'Electric Installation Verification
(l~lectricf0 Co~tor
(l~s~) (City) : (Sta,~ (Zip C~)
havo ~en con~a~ to perfo~ clec~ in~fion work fo~ ~~_
(A~ress wh~re work will be
The nature of the work c~yad~,ts of:
(Chc~k eric or Describe thc Nalut'e of Wink)
Rccormection or Ilcw circuit for replaocmalt Heating Plm~t and/or A/C Condenser.
Ro~onne~tion or new circuit for rcpl~emet~t Electric Watc~ He. ntct or po,d, et voiltett
water heater.
ReconJlection ofl~ Sorvioe EntrL.~ce Cable. M~t~r Box, aheratim~s to rcc~taclcs
anti lighling fixtur~ due to ddm~ / soffit i~JtalLItion. Note: Now S~rvice
llntrance Cables will l'~quixe a I~arat¢ p~rmit.
R¢¢onne~tion or new circuit for the replacement of other pesmaflcnliy wired
appliances / r~tturu.
Now circuit for the addition orA/C to an mdlvldu,l d~ali~ Jmit (hmtso oF thc
individual systems in a dupkx or condominium), i~oludin8 required aorvioo
electrical outlets.
Other
Tl~e vnlue of this work is S I.,~},. ~,
I hereby verify this wm'k will bc performed by an employee of this company and ~rtlMr vcrifS,
the re~om~¢ction ! instillation will be done in compllinc~ wiil~ mnnufacturer ned ]~Motric code
requirements.
(Print Nnn~ of
a.
(Dat~)