HomeMy WebLinkAbout0102839-HVAC (a/c)OSHKOSH
ON THE WATER
Job Address 649 W 6TH AVE
Contractor TENTH STREET STATION INC
Fuel I J Gas
System [] New
L~ Forced Air [
I,,,I Electdc I
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Chimney Type ~} ChimneyA
Owner JAMES D DAHLKE
Category 501 - Residential-Air Conditioning
LJ Radiant
Hot Water
I¢.1 Electric I Id Solar
[] Replace I
Steam I L~J NC
suppL I I Icon. Burner
Direct Vent ~1 Not Appliceble I
Chimney B
Heat Loss ~,,~ As Approved O Existing
BTU Rate ~ ~ As Per Plan (.~ Vadable
Not Applicable I Value
Other I Value
No 102839
Create Date 07/07/2003
Plan
I
[] Other
Vent
0
24m ntu
Use/Nature .~FPJ Install new A/C. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$1,441.78 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided J
$27.50
Date 07/15/2003
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
FROM :TENTH STREET STATION, INC. FAX NO. :920-2~-0150 Jul. 07 2~3 10:1lAM P7
City of Oshkosh
Division of Inzpcclion Services
P,O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236.$050
Fax (920) 236.5084
O/ KO/H
HVAC PERMIT APPLICATION
All information after bold categories taus! be provided.
Incomplete app]icalions will not be proc~sed.
Application(s) and fcc(s) oan bc brought to City Hall, Room 205 or mailed to Inspection Sendccs, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is ~rcatcr,
OR
lf ¥ou ore a contractor participating in the Permit fee Account System and have ~deouate funds, check here
if_~ou_~a~t.th~$ processed through ¥ou~ account ~t~
CHECK [] ALL APPLICABLE
USE CATEGORY
li~6inglc FamiIy EIDuplex
ElMulti-Famity ElR~ntaI
ElCommcrcial
[3Industrial
FUEL il(Sas ll~l¢clric r'lSolid
v1Oil ' . V1Solar
TYPE
E]Forced Air
[~Radiant
SYSTEM
C]Steam I;~A/C Clvent UElec~c
I'-IReplace
vii-lot Water ElSuppl.
& MANUFA~R
IS cHIMI~Y BEING LINEI}d~o I'lYes L LINER SIZE
Note: All chimneys shall be ~ized per the BTU's being vented.
CliliVINEY TYPE ElChinmey A ElCMmney B ElDirect Vent ~Other
HEAT LOSS VIAs Approved ~Existing ~qot Applicable
.T TE nA P an nVa able l th V.l e vve
UCon. Burner
(Including labor and al] materials including light fixtnres) $ ['~14 [, 76
~For applicable projects, an l~lectrio imitallation Verification form, signed by tile t~leotrical Conlractor, must be
at:ached. If not attached or not applicable, a separate Electrical pernut is requtred.
FROM :TENTH STREET STATION. INC. FAX NO. :920-2J6-0150 P8
I (We)
Jul. 0? L~0~ 10:12AM
Electric Installation Verification
(Address)
(Hlec~cal Contractor Name)
(State) (Zip Code)
have been contracted to perform electric installation work fo ~f~~
(Name of party contracted to)
(Address where work will be performe, xl)
"'. The nature of ihe work consists of.' (Che~k One or Describe the Nature of Work)
~ Reconnection or'new circuk for replacemen~ Heating Plall! mid/or A/C Condenser.
~ Recormection or new circuit for replacement El0ctric Water Heater or power'vented
waier heater.
- Rec°nnection of thc Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cablea will require a separate permit.
~ Rec°nnection or new circuit for the replace, ment of other pe~mlanently wired
appliances / fixtures.
New circuit for the addition of A/C t~ an individual d~dling unit (house or the
individual s~stems in a duplex or condominium), including required service
cl¢cixical outlets.
.... Other
The yalue of this work is $~- ~
I hereby Vet/fy'this work will be p~rformed by mi employee ofth/s company and further verify
the r~onnection / installation will be done in compliance with mauufacturer and Electric cod
reqmrements. ~ e
(Signature {6f Company Officer) ' '(Print Name of Officer)
(Date)
$/O2