HomeMy WebLinkAbout087507 - HVAC (furnace) 0 CITY OF OSHKOSH No 87507
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2009 MOUNT VERNON ST Owner MANUEL MARTINEZ&WIFE Create Date 05/18/2001
Contractor TENTH STREET STATION INC Category 500-Residential-Heating&Ventilating Plan
Fuel 0 Gas I I I Oil I Electric I Solar I I Solid
System [] New j n Replace I [] Other
0 Forced Air Radiant J Steam
[.J A/C J Vent
Electric I I Hot Water Suppl. I Con.Burner
Chimney Type Chimney A • Chimney B ❑ Direct Vent 0 Not Applicable
Heat Loss Approved • Existing O Not Applicable Value
BTU Rate As Per Plan U Variable 0 Other Value 75,000
Use/Nature SFR/REPLACE FURNACE
of Work (No electric permit required-received installation verification signed by My Electric)
Fees: Valuation $1,748.66 Plan Approval $0.00 Permit Fee Paid $32.00
Issued By: • Y~
Date 07/11/2001
❑ Permit Voided
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
s
05/16/2001 01:37 9202360150 TENTHSTREETSTATION PAGE 04
Civis104 of Inspection Services
215. Church Avenue
F.O nox 1130
�!(((� ����I�7 nehko-h, WI 54903-7,130
'- '_ E'ax 4 (92c ) 236-5080
on+3 i54Q! 236-5C99
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided
Incomplete applications will not be processed.
DATE 6//�p {ii
JOB ADDRESS ZOo' 11tf', '+0,4,N 6/(q
Pi
CONTRACTOR —limA4AL9VYtillAlUA -
CIRCLE ALL APPLICABLE
USE CATEGORY e,TNGLE FAMILY DUPLEX MULTI-FAMILY COMMERCIAL INDUSTRIAL
FUEL
OIL ELECTRIC SOLAR SOLID
SYSTEM NEW CLEZI CE OTHER
TYPE RCED AIR) RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED NO tSTI INER SIZE C '} y
MANUFACTURER
Note, All chimneys shall be sized per the ETU' s being vented.
CHIMNEY TYPE CHIMNEY A Y DIRECT VENT OTHER
HEAT LOSS AS APPROVED ^� NOT APPLICABLE
ETU RATE AS PER PLAN VARIABLE OTHER VALUE 750003
NATURE OF WORK: ft-elk,Ate i(•4t2AIfM• LJ TL4 Bc.20 FL4f2g1►9L.
VALUE (Including labor and materials) S_ 0'7'18.04 "-et. Y 3.00
ELECTRICAL, CONTRACTOR CONTRACTOR 1 / CY5G vL_
Electrical installation of new/replacement equipment shall be done by licensed
contractors.
Valuation
Fees
SO Co $1, 000 . 00 $~
$20 . 00
51, 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 $155. 00 for firs:
$10, 000 . 00 plus S1 00 per $100 . 00 valuation or part e;-i.,,rec::f
Over $25, 000 _ 00
S30S 00 p_,uts
per 5100 . 00 valuatic'n ar gait ch(!.,-eo
• S,lbmit payment with application. Failure to pay within 30 days ail '_ -es : ! : r•
f`e?s beind do:1 led or S100 . 00 plus the normal permit tee, which _:per
greater .
MAY-21-2001 08:49 MY ELECTRIC CORP. 920 232 8900 P.02
N.
City vi Oshkosh
S r4, DInz of I ionofII'pcc on Ssniess
C.,)
71f ChuckAwnuw
PO Box 1130
Mee M 9
1-1 54902-1130
Ofice 20�7.iL30f0
ON fa 1WfI Fu 920.2363014
Electric Installation Verification
(I}(We) MY Electric Corp.
(Electrical Contractor Name)
1512 Rugby St. Oshkosh WI 54902
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for Tenth Street Station
(Name of party contracted to)
at the following address; 2009 Mt . Vernon St. •
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
X Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable,Meter Box, alterations to receptacles and
lighting fixtures due to siding/soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances/ fixtures.
Other
The value of this work is$ 100.00
I hereby Verify this work will be performed by an employee of this company and further verify the
reconnection/installation will be done in compliance with manufacturer and Electric code
requirements.
�'Lo tail, Eric Youngbauer 5 /19 /2001
(Signatur o omp Officer e)
Officer) (Print Name of Officer) (Date}
TOTAL P.02