HomeMy WebLinkAbout0099885 HOSHKOSH
ON THE WATER
.lob Address 1080 N WESTFIELD ST
Contractor MARX MECHANICAL LLC
Fuel
System
Gas J ~J Oil
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner EVERGREEN RETIREMENT COMM INC
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99885
02/20/2003
Other
Vent J
Use/Nature
of Work
Replace furnace. *EIV form from Beez Electric.
Fees: Valuation
Issued By:
$2,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$48.50
Date 02/20/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number
(920) 235-6510
C£ty of Oshkosh
Division of Inspection Services
P.O. Box l t 30
Oshkosh, Wt 54903-1130
Phone (920) 236-5030
Fax (920) 236:5084
ON IMF WATER
HVAC PERBI
Incomplete applicafio~ will :ffe~0~
Osl~osh WI 54903-t 128. Commencing work w~thout pen~t(s) will result ir doubled or $] 00.00 plus the
no~al pe~t fee, which ever is ~eater.
OR
Jf ¥ou are a co~~~e PeWee Accoun~stem a~,d have ade~12ere
~ want t]~.is rocessed lhrou h ?our accouter ~
co :m, c:ro i'4
CItECK [] ALL APPLICABLE
USE CATEGORY
l~mgle Fmnily [tDuptex ltMulti-Family tDRental
[] CommercJ al
[] hxdustfi al
FUEI~ IB~as
~.'Oil
TIrPE
Iii,Forced Air ~Radiant
IS C~Y BErG LI~D ~No ~es - L~R SIZE
Note: All chh~meys shall be sized per the BTU's being vented.
12]Eleclric []Solid
E]Solar
SYSTEM
[]Steam E]A/C IDVent 12]Electric
[] Other
[:]Hot Water [DSuppl. 12ICon. Burner
& MANUFACTtJILER }:~C-~G - I
CHIMNEY TYPE
~ .tEAT LOSS
BTU ILATE
U]( :himney A
[3As Apl)roved
E]As Per Plan
[] Chimney B
[]Existing
[]Variable
E]Direct Vent
F]Not Applicable
F']Other Value
E]Odaer
12 For aPp,icab!e proje'~s, an Electric IP,~St~ila!i~;~ Veril~¢atR)n for,n, sip. ned by tl~c :';lectrical Contra'trot, musl be
al!: cheo. tfnot ~itachcd or not applicag!e, a sepa?le I.~ectnca] Pcnnit is required.
~/o2
EEEZ ELECTRIO
PAGE
oi
Electric Installation Verification
(I) (Wa) ~ [nc.
521 W. 12th .O. ab&osh WI 54902
have been contracted to perform electric installation work for ~e..ch~nical ~¢.,
at the following address: Evergreen Village 200 Apt 214..
The nature ofthe work consists of: (Check One or Describe the' Nature of Work)
[]
0
[]
Reconnection or new eirmit for replacement Heating Plant and/or A/C Condenser.
l[econne~tion or new dmuk for replacexrtent Electric Water Heater.
Remrm~¢tion of the Sm'vice Entrance Cable, M~ Bo~ ait~atiom to receptacles ~
lighting fi~s due to siding / soffit imtatlafion. Nora: New Semice ~ce Cables
~11 require a serrate p~k.
Regonnection or new fitcffit for ~r p~anmtly ~red app~s / fi~res.
Oth~
The value of this work ia $1_50_.00
[ hereby veri~y this work will be p,rform,d by an employ~ of'this company ~d further verify 'the
meOnneetion / inst~llaIion wilt be done in complianee with mmnufacturer a_nd Electric code
requirements.
(Stgrtatur~ &Company Officer)
Gary Bi,sin~ 01/23/03