HomeMy WebLinkAbout0096020-HVAC (a/c)
e
OSHKOSH
ON THE WATER
Job Address 885 HARMEL AVE
CITY OF OSHKOSH
HV AC PERMIT - APPLICATION AND RECORD
No
96020
Owner EUGENE/WINIFRED BREWER FAMILY TR
Create Date 07/16/2002
Contractor TENTH STREET STATION INC
Fuel U Gas I Oil
System ~ New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type U Chimney A () Chimney B
Heat Loss () As Approved () Existing
BTU Rate () As Per Plan () Variable
Category 501 - Residential-Air Conditioning Plan
L J Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
. Not Applicable
~ Electric
o Replace
U Steam
I I Suppl.
() Direct Vent
. Not Applicable
. Other
Value 0
Value 2 ton
Use/Nature SFRllnstall new a/c with duct system. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By: kl-V'\
$3,700.00
Plan Approval
$0.00
Permit Fee Paid
$60.50
Date 07/22/2002
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ON THF WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
. 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) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
Ifvou are a contractor TJarticiTJating in the Permit fee Account System and have adequate funds, check here
i ou want this rocessed throu h vour account
DATE
'7/I'~ (0 "L.
. JOB ADDRESS ~1(?5 (fe,v. ~
'O'~'ER'(~ 8~
CONTRACTOR . 'H~ S--I. S~t;,-
CHECK 0' ALL APPLICABLE
, .
USE CATEGORY
pgSingle Family ODuplex DMulti-Family
DRental
OCommercial
o Industrial
FUEL
DGas
DOil
~Electric DSolid
DS<;>lar
SYSTEM
lifN ew
o Other
DReplace
TYPE
DForced Air DRadiant DSteam ~NC DVent DElectric DHot Water DSuppl.DCon. Burner
IS CIDMNEY BEING LINED ~o DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER_____
CIDMNEY TYPE DChimney A DChimney B DDirect Vent I}l.Other
HEAT LOSS DAs Approved OExisting ~Not Applicable
BTU RATE DAs Per Plan DVariable IfOther Value Z 70'"
DESCRIPTION OF ALL WORK BEING DONE~Ni41/ AIC W,/ ~J-S~~-
VALUE (Including labor and all materials including light fixtures) $ 37()(,).. crv
r:ee :.$ ft,O. ~
OR ~Iectric InstdUation Verification form attached(Jf Replacement) .
Electrical installation pf newlreplacement equipment shill! be done by licensed contractors.
ELECTRICAL CONTRACTOR
3/02
.
~
~QIB
City ~t Oahk",h
Di.i,ion of ln~peclion S."ice~
lIS C"-~ A....n..
.PO !:lox 1130
O.lIkccl, Wf $4\1O)-IIJo
Olii;c 9:l1)..2J6.$050
1'.. ~)().l36.$(JH4
Electric Installation Verification
I (We)
o rv;; )<'1- r;-te
r.LiFeTIC j c...
(Electrical Contractor Name)
_FF PiCt<.e"Tr
(City)
yqo m {<.o
(Address)
W;I',
(State)
J.~q~ 't
(Zlp Code)
have been contracted to perform electric installation work for -1i.1i.I1il- ..$T~..a'i :;:-n'lTr(j ::!.
(Name of party contracted to)
)? 1:;- II tf IZ. (114 /:;;-"1-
(Address where work will be perionned)
-~~"'
at the following adw'ess;
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 Ale Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Recol1nectiOlJ of the Service Entrance Cable. Meter Box. alterations to receptacles
and lighting fixtures due to siding I soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanentI>, wired
appliances / fixtures.
New circuit for the addition of Ale to an individual dwelling tmlt (house or the
individual sy'Stems in a dupiex or condominium). including required service
electrical outlets.
Other
The value of this work is $ /OD,. c:.r-J
I hereby verify this work will be perfonned by an employee of this company and further verify
the recorlnection / installation will be done in compliance with manufacturer a.'1d Electric code
requirements,
/ud......
fCompany Officer)
RiLl./f' Dr D,e&'ld.I;~
(Print Name of Officer)
~~ 9- 6 rl-
(Da.te)
S/02
Z:O.d
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