HomeMy WebLinkAbout0134214-HVAC (furnace)CITY OF OSHKOSH No 134214
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 668 W 5TH AVE Owner STEVEN UGUDRUN HEMMINGHAUS Create Date 09/19/2008
Contractor TENTH STREET STATION INC Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric____] (^ Solar. ' ^ Solid
System ^ New ~ / Replace ^ Other
/ Forced Air Radiant ^Steam ~ ^ A/C , ^ Vent
Electric Hot Water (~ Suppl. Con. Burner
-----J
Chimney Type Chimney A Chimney B Direct Vent Not Applicable ^
Heat Loss As Approved Existing Not Applicable ~ Value
BTU Rate As Per Plan Variable Other ] Value 70,000
Use/Nature
of Work
_rv~ct ruKNAC;t, tIV SIGNtU 6Y DREXLER ELECTRIC **debt acct. 17/1f
to address license and fee issues.
****"" EXPIRED LICENSE WITH THE STATE OF WISCONSIN **************"
*"** NOT ENOUGH FEES IN DEBT ACCT ""**
to respond to 3
Fees: Valuation $1,600.00 Plan Approval $0.00 Permit Fee Paid $134.00
Issued By:
^ Permit Voided
Date 12/01 /2008
Parcel Id # 0603220000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 924 OHIO STREET OSHKOSH
WI 54902 -0 Telephone Number 236-8770
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
OM :TENTH STREET STATION, INC. FAX N0. :920-236-0150 Sep. 19 2008 01:15PM P1
City of Oshkosh
Division of Inspection Services
P.O: Box 1130
Oshkosh, WI 54903-1 ] 30
Phone (920) 236-5050
Faz (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applicatio~ls will not be processed.
HKQ1H
ON 1'r;p wpTFR
• Application(s) and fee(s) can be brought to Ciry Hall, Room 2U5 or mailed to Inspection Services, YO Box 1 128,
Oshkosh WI 54903-I 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
. normal permit fee, which ever is greater:
OR
1 ou are a contractor artici grin in the Pe,-mir er Accnunr Svsrem and have ade uate unds~`ehec
i ~ uu went this r cessed throe h our accvtrnr
~~ . ~ DATE ~'"/S"'-D e3 ~. .
JOB ADDRESS 8 ('`~ ~ -
OWNER ~~'~ ~f~w~i`n (ngGws' .. .
~..
.CONTRACTOR ~~v`~•~ S-i~ Sfw~to,~ ~ w~ .
.. COCK 0 ALL APPLICABLE
USE CATIEGOR'St
Single Family C7Duplex ^Multi-Family ^Renta! Commercial ^Industrial
FUEL 1~Pas ^Electric OSolid SYSTEM
^Oil ^Solar ^New Replace
OOthcr
T'YpE .
^Eorced Air ^Radiant ^Steam 17A/C ^Vent ^Electric ^Hot Water ^Suppl. ^Con. Burner
IS CT~MNE7i' BEING L1CNEb f~IVo QYes -LINER SIL>~
Notc:.All chimneys shall be sized per the BTU's being vented. ~ & MANUl;AC121R.ER
CI~IMNEY TYPE ^Chitriney A 'l>xJChimney $ ^Direct Vent ^Other
SAT LOSS ^AS Approved ~.Existin
BT'I.J ATP ^As~PCr Plan g C7Not Applicable
^'Variable l~Other Value '70 da0 ~7k~6j
DESC~~IIPTIUN OF ALL WO)~{ BEIlYG DONE
JI,_-~ _ .
VALUE (including labor and all materials including; light fixtures) $ f (DOp, t7`~
ELECTRICAIL CONTRACTOR D . ; [ ~ ]
~~f-~7'L
SEP-17-08 WED 08:32 PM HEMMINGHAUS Oshkosh, WI 920 233 2221
Ci~y of Oshkosh
~,.•~sim~ ol'li~socalun Ser••ice>
l5 Churph A~~en^c
T'!? ~n:~ 1 ~ 9D
J G••;hreshwl 5~9na-113
_
~ ,fir :'+fficn n'_o-z9i~5DSu
~ ,`I`T4~~cr,
~~CC~1"l.C I11Stal1ati0~? ~TCi'iflCatiOXl
P. 01
~~ (Eleclric~l ContractorNat~le)
(1'1d~iress) -- -- (Cityl (State) (GIp Load
_ _ ?~ off,
"tt~ ~ e; been =ontcacte~i to perform elcrtxie jx7~;14~l~ation w ork for ~~ m o:f arty eonu'ac~ d of
~ p ,
~-t t'.•-e fotlr~win~ address:
~ `~`
r
w..
(Address where work tivill tie performed)
~"x~e nature of. the work cotasists al': (Checl~ One or Describe the ~.tature of Work)
~' ~cconnect:ion or new circuit for replaccr-xez-t rleatitlg Plant andlor A.!C Condenser.
~'~=~ Recunne:-1:ion or nevv circuit fir cPplao~mei~t ~lECtzlc Water Heater yr power ~rent~t3
watf:r heater.
_ ~? „conn~etivn of t'be Service Entrance Cable, Meter Box, alterations to receptacles
~M a-~d lighting fixtures due to siding / soffit installation. Note: ~Ievv Service
~itrance Cables will req,u.ire a separate 1?ern~it.
iZceQ-rneetion or -iew circuit for tkto replacement of other ne~rxr-anently wired
~w appliances / fixtures.
.New circuit tot tt•-~* ac!.d~tion of A/C tv an indrvrdual dw~llfr-g ~a-ii (lao~-se or the
iridlVidual Sjs5tet118 ire a QUplex or condullliniumj, inciudita~ xccj~,cired service
elect-~cal outlets.
_____ Other
pv
.~";~te value of this work zs ~ ~..._.-•
7 hereby verify this work will be perfoma~d by axe employee of this conlpazty and further verify
the recorneclaon ! i-astallatioza will be dc~lze in coxnpliarlce with manufacturer and ~lcekric code
~-agt-ire~x~-:z~ts.
~~ ~ , ~ ~g
r ~~ Print i~atne of Officer) (Date)
(~ig-a'tt:re ~{ Company 0£~Cez) (
s~o2
i r1 • f nn s 7 i ~ ~ n-7n i gnu yr t 7 ,e ~ n ~ n,~~n-~ r -, a ,.n . ~~~ ~ h~ • ~ ~ ^~~ < •.n,., n ~ •^in