HomeMy WebLinkAbout0090648-HVAC (a/c)
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OSHKOSH
ON THE WATER
Job Address 851 HARMEL AVE
CITY OF OSHKOSH
No
90648
HVAC PERMIT. APPLICATION AND RECORD
Owner JOHNSON REV TRUST
Create Date 09/12/2001
System
D~e_~_~_______.-J
U Forced Air U Radiant
U Electric I I Hot Water
Category
1,(1 Electric
[?] Replace
U Steam
I 1 Suppl.
() Direct Vent
Plan
Contractor
TENTH STREET STATION INC
Fuel
I 1 Gas
I Oil
1
-~
I
I
I I Solar I Solid I
o Other_~__ __~
~ AlC U Vent I
I I Con. Burner
Heat Loss
U As Approved
K:) As Per Plan
() Chimney B
() Existing
() Variable
() Not Applicable
Chimney Type U Chimney A
BTU Rate
. Not Applicable
() Other
Value
Value
Use/Nature SFRI Replace 2 Ton AlC. *EIV from Drexler Electric attached
of Work
Fees: Valuation
$1,350.00
Plan Approval
$0.00
Permit Fee Paid
$26.00
KM
Date 10/18/2001
Issued By:
o Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
924 OHIO STREET
OSHKOSH
WI 54902 - 0
Telephone Number 236-8770, MOBILE 7
08/24/2001 20:19
.~........,_. w.
9202350150
TENTHSTREETSTATION
~
O~tKQ{H
Division of !nspcccioS'l Serv!"l!S
21S Chureh AVenue
P.O. !:lox 1130
OshlcO$h,l-ii 5.. 903 -113 0
f"", A ($:lQI 236-5<>1)<
Phone (920) 236-5046
~
HVAC PERMIT APPL'ICATION
Al~ fIelds/informacion afcer oold ca~e9ories m~st be provided.
Incomplete applications will not be processed
DA'l'E f:;/2.~O.!. .___"___
Joe ADDRESS E!f5/ f..\.Aa1U6-:-L
OW~R ~1Jt~:r=:;-lO'7~'?;V
CONTRACTOR JcIVTH: sr~ S~171,~ !A/c.
CIRCLE AJ,.I.. APPLICA'OLF.
OS~ CATEGORY ~
DUPLEX
;rUEL
MULTI -FAMILY
~
~
SOLID
COMMERCIAL
~N:)~3n!AL
GAS
DTT
~.....
SOLA..,
~~STEM
NEW
OTHER
~YPE:
fORCED A r r-:
RADIANT
~>u
STEA."1
VE~T
ELECTIUC
HOT WATER
SUPPL.
CON. BURNER
S CHIMNE~ BEING LINED A..JO LIN2R SIZE
ate: All Chimneys shall be Si2~d per the BTU's being Vent~d,
/"1.A.NU F AC'UR !C. ;
HI~Y TYPE MIA-- :riIMNEY A CHIMNEY B D LREe'I"-'VEN1- j";T:-!c;:::
~T LOSS AS APPROVED EX I S::-ING ~ M'PLIC~
rtJ RATE AS PEL PLAN VAR,l:J':I.BLE OTP.!.:;I" VALUE 2"Ul^""
\TtiRE OF WORK:
rk--Pf,Jf{:E
"Z.- 7'P,"V Ale.
\.LUE. (Including labor
Fc~'
.f; .2 fa. crt)
,EC7RICAL CONTP~CTOR
e~t~ical installatiDn
n:ractors.
and materials) iL-3S~~~
[) f1~-v..{;c--rL- I.:;;.~~
of nd'.4l:'eplacerr.e:,.t ~quipment shall be done by licer:seC\
l'..1ac ion
Fees
':0 S 1, '000 . 0 0--.....:...................................................._......._.................................-.............................$ 2 0 . 00
, () 00 .0 lto $10,000. 0 0.........................................._........................................-......................S2 0 .Q 0 f O~ : 2. ~ s:
S1, 000.00 plus S1. 50 per SlOO. 00 valu.at.ionor pa~;~ ::.t;.:.::=o~.'
O. 000,01 to S 2 5, 000. UG..................................... ...........................................................5255.00 :0:( :::. ",,:
C10,00UUO plus SlOO p~r $10000 va~uatiDn or pa~~ t:l=~~Q~
;!;:,- $25, 000 . 00................;...............................
.--............................................................5:3 05.0 0 plus so.:; ')
per $100.00 vall.l.;l,cl.on or part. c.:.:>~;::eo::
Subrr.it payment. w~t:h application. Pailu.:'e to pay wit:hin 30 cays will ~'"81.1:
fees being doubled OC $100.00 plu:; t~l'" nurn'."'~ pe:Z:'l1'l t: t'0e, '~'~1). ci~ CV~ ~- ; ,0
s::'"ester.
,. :, r;
PAGE
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Q/H<O.IJ:j
0.. 'ME _TE~
City of Othkooh
DiYi.icm oflnJplClion SclYlm
21~ Chun:h A""n..
pO Doa IlJO
O.hI<ooh WI 54902-1 UO
om.. 92o.2J60'0'0
F"" '20.2]6-5084
Electric Installation Verification
~...J) a. IG )t L e-1t &::. L ~C'\ 'tZ-1 ~ L
(Electrical Contractor Name)
y ~ 0 r. +Y P.. J.,. F fZ- P I'Ll<. e"IT vJr S11 q ,tJ
(Address) ~ity) (State) (Zip Code)
have been contracted to perform electric installation work for~ ,J +-" $TIt B. -t t ,..J e A-;T -t 0> 0 \
(Name of party contracted to)
at the following address: <(57'~tr::~~7l'ST~~"",g
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
~
Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fix.tures due to siding / soffit installation. Note: New Service Entrance
Cable5 wilt require a separate pennit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value ofthis work is $ .J::O I liu .
I hereby verify this work will be perfonned by an employee olthis company and further verifY the
reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
~QD~
(Signature fCompany Officer)
PH ,1~1 t (). ?JtU/t! (.
(Print N.me of Officer)
~
(Date)
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