HomeMy WebLinkAbout0084089-HVAC (furnace) e l)1 CITY OF OSHKOSH N 84089
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1936 MICHIGAN ST Owner MARY ANN BEARWALD ETAL Create Date 01/02/2001
Contractor TENTH STREET STATION INC Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas 011 Electric Solar Solid
System New ✓ Replace Other
✓I Forced Air 1 Radiant Steam _j A/C I Vent
Electric Hot Water ] Suppl. Con. Burner
Chimney Type ) Chimney A () Chimney B • Direct Vent O Not Applicable
Heat Loss ) As Approved • Existing () Not Applicable Value
BTU Rate ) As Per Plan () Variable • Other Value 75,000
Use /Nature SFR / REPLACE FURNACE AND LINE CHIMNEY
of Work
Fees: Valuation ,, Plan Approval $0.00 Permit Fee Paid $42.50
Issued By: m S Date 02/06/2001
Permit Voided
In the performance of this work, 1 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
12/21/2000 00:58 9202360150 TENTHSTREETSTATION PAGE 02
442/1 Di vision lnapeerion services
215 Church of Avenue
f P.0. Box 1130
�S«�T�Ff— oehkosh. WI 53903-1130
Fax 8 + 920) 236 -5084
qajW
Phone (9201 236.5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete ap.piications .will. not- be processed,
DATE / Z /24,00
JOB ADDRESS /9z /•� MM l4Ar`�otn
OWNER goiry YbitNi , ✓/
CONTRACTOR ( 7 0 5 71'I f !nt _
CIRCLE ALL APPLICABLE
USE CATEGORY I GLE FAMIL UPLEX. MULTI- FAMILY. COMMERCIAL INDUSTRIAL
FUEL - AS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLA OTHER
TYPE FORCED AIR_,) RADIANT STEAK A/-C VENT
ELECTRIC HOT WATER SUPPL, CON. BURNER
IS CHIMNEY BEING LINED Y35 LINER SIZE II" MANUFACTURER W rk-
Note: All chimneys shall be sized pe -r:th BTU's
CHIMNEY TYPE CHIMNEY A CHIMNEY B pIREC VENT OTHER
HEAT LOSS AS APPROVED EXISTI „ / NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE /1 OTHER VALUE 7$67'6
NATURE OF WORK : 4, 4,4_ A%4 ....L.. r./ f 7 Oo o 9d r 4 ti 44 "viol /: % , ,••^.
VALUE (Including labor and.materials). #tO,00 �'CC
s tn. 5A
ELECTRICAL CONTRACTOR 5eC4 t t &E ax c.+
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
SO to $1,000.00 $20.00
$1,000.01 to $10,000.00 $20.00 for first
$1,000.00 plus. $.1.50 per $100.. 00_ valuation or part thereof
$10,000.01 to $25,000.00 S155.00 for first
$10,000.00 plus $ ion or part thereof
Over $25,000.00 $305:00 plus $0.50
per $100.00 valuation or part thereof
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $ 100- . p:lu•the-flormal permit:fe.e which ever is
greater.
FEB -13 -2001 14:04 MY ELECTRIC CORP. 920 232 8900 P.01
City of Oshkosh
Division of inspection Samos
ltS Kl rui u Avenue
)
PO lee U30
Oshkosh WI S4902.1130
01§ce 920.2745030
f w Fax IRO- 2364O$4
Electric Installation Verification,
(I) (We) MY Electric Corp.
(Electrical Contractor Name)
1512 Rugby St. Oshkosh WI 54902
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for Tenth Street St at i on
r
(Nameo€pe€ty contracted to)
at the following address: 1936 Michigan S t .
(Address where work wiffbeperfonrIed)
The nature of the work consists of (Check One or Namto of Work) .,
X onnection ornew c rcuit for replacement - KeatingPlant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of Set EntranceCah ;Meter -Box alterations to receptacles ands .
lighting- fixtures due to siding t soffit installation. Note: New Service Entrance
Cables win require permit:
Reconnection nr rtew .circuit_for oather,perma>teatly_wired appliances / fixtures.
Other
The value of this work is S 100.00
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will •bedou arrd Electric code
requirements.
"Lt� t Eric - Yours bauer m O ffice 2113
(Signature of
_ —_ P � (Print Tame of (Date)
FEB -28 -2001 16:09 MY ELECTRIC CORP. 920 232 8900 P.01
(11111). City of Ocldcoch
8 L I S
[Avicioa of Imoteooa Swims
21i Chmn.h imam.
PO Bout 1130
(:)./H1011-1 OtWrosh 11x1 54902.1130
MN 920.7364050
0►. T..4 v•fla Fax 920 - 2311-3014
Electric Installation Verification
a(We) MY Electric Corp.
(Elee.tficai.Ce ractoz•Name)
1512 Rugby. St — _ Oshkosh... - WI 54902
(Address) (City). (State) (Zip Code)
have been contracted to perform electric installation work for Tenth Street Station
(Name of party contracted to) -
at the following address: / M C / Q
• (Arldress will be performed)
The nature of the work consists - of : (Check One or Describe Nature of Work)
X Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser_
Reconnectio ar new circuit for replacement Electric .:W ateri eater.
Reconnection.ofthe Service_ Entrance Cable, Meter -Box, alterations to receptacles and -
lighting f xturesdt3c Krsiding Csoffit'installation: Nose: New Service Entrance
Cablcs will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other.
The value of this work is $ 100.00
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation v bed compl - with:m ac erand Electric code
requirements.
/414P ' Eric Youn Bauer-
$ 2 /13/2001
(SignaturFo amp : y ( cry (Print Name ofOfcer) - (Date)
TOTAL P.01.