HomeMy WebLinkAbout2003-HVAC (furnace, a/c)OSHKOSH
ON THE WATER
.lob Address 340WESTBROOK DR
Contractor TENTH STREET STATION INC
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner HARRIS/DOLORES KRAASE
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B O Direct Vent ~ Not Applicable I
Heat Loss ]~ As Approved O Existing ~ Not Applicable ] Value
BTU Rate ]~ As Per Plan ~) Variable ~ Other ] Value
No
Create Date
Plan
L~ Solid
104253
09/18/2003
Other J
Vent J
75m btu heat
Use/Nature SFR/Replace furnace and add new A/C. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$3,300.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$54.50
Date 09/18/2003
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.
FROH ;TENTH STREET STATION, INC, FAX NO. :920-2'3~-0150 Sep..~18 2~3 08:~2AM P1
Ci~ of Oshkosh
DJYJsjol~ of ]llsp~ctiol:t Services
P.O. Box 1130
Os~osh, WI 54903-1 I30
Phone (~0) 236-50~0
F~ (920) 236-~084
HVAC PERMIT APPLICATION
All information after bold cmegofies m~st be provided.
Incomplete applications wi I not be PZocos~ed.
· Application(s) and £ee(s) can be brought ~o Cily Hall, Room 205 or mailed to Inspection Services, PO Box 1128.
Oshkosh WI $4903-1128. Commencing work wilhou~: permit{s) will result in fees being doubled or $100.00 plus the
normal permit fee, which eVer is greater.
OR
COlVr~CTOR
CtlI~CK [~ ~ APPLICABLE
U~ CATRGORY
~qSingle Family E]Duplex E]Multi-Family l'lRental [~Commcrcial
FUEL ~Gas r'~Elcctrio rlSolid SYSTEM ~New
1-10il , D$olar [~Other
Ellndustrial
T E
~o~ed Air r'lRadiant ElSteam [~C i'lV~nt ElElcctric rlHot Water I'lSuppl.
I$ CHIMiVEY BEING LINED ~o CIYcs - LINER SIZE & MANU~A~
Note: All chirrmeys shall b~ sized per the BTU's being ventcd. ~/~1~{7/~ ~
CHIMNEY TYPE [2Chimney A ~Chimney B l~reot Vent t-lUther
HEAT LOss V1As Approved ~Existing E]No! Applicable '~','o~
BTU RATE FlAt P~r Plari glVariable ~Olher Value ~-r,,~
DESCRIPTION OF
AI,I,
WORK BEING DONE
EICon. Bla'ner
V,~I.,UE (Including labor and afl materials including light fixtures) ~$OD
~/~For applicable projects, ~n Electric Installation Verification form, signed by the Igle~ical Con~'actor, must be
ar[ached, It'rlot attached or not applicable, a separate Elcc~'ical Pen'mt is required.
FROM :TENTH STREET STATION, INC. FAX NO. :920-2~6-0150 Sep. lB i:~3 0@:~3~M P2
Electric Installation Verification
(Electrical Contractor Name)
__ ."~"~'-'
(Addr s) "(cit )
(State) (Zip Cod5
have been contracted to perform el~dc installation work for .~h/'['~ ff, Ti¢~U ~'/'l~T~a _~,
(Name of party contracted to)
at the following address: 3~0 b~e. 5'~/~/~
(Address where work will be performed) -'
The nat~e o£the work consists of: (Check Oneor Describe the Nature of Work)
~. Re, connection or'new circui~ for replacement Heating Plant md/or A/C Cond~mer. ·
Reconnccuon or new circuit for replacement Electric Water Heater or power vented
' water heater.
R~-.nnnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lishti~g tixtures due to siding / soff~t h~'tallatio~. Note: New Service
Entrance Cables will require a separate perm/t.
~ lqewctrcmtfortheaddltaonofA/Cto~zndf~4d~aldw~thnguntt(houseorthe
individual systems in a duplex or condominium), including required servile '
electrical outlets.
~ Other
Thc Value ofth/s work is $ ~-.00, O~
I hereby verif~ tltis work will be perfo,-med by an employee of this company and further verify
thc m. connection / installation will be done in compliance with manufacturer and Electric code
reqmrements..
(Signature o~ Company Officer)"
(Prir~ Name of Officer)
(Date)