HomeMy WebLinkAbout0101392-HVAC (furnace)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 825 FRANKLIN ST Owner SHELDON L FIEDLER TRUST
Contractor TENTH STREET STATION INC Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas J ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 75m btu
No
Create Date
Plan
~J Solid
Vent
101392
05/09/2003
Use/Nature SFR/Replace direct vent furnace. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$2,100.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$36.50
Date 05/09/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 924 OHIO STREET OSHKOSH WI 54902 -0
Telephone Number
236-8770
FROM :TENTH STREET STATION, II, lC. FAX NO. :920-236-0150 Maw. 09 21~3 12:2'?PH P~
CiW of Oshkosh
Division o£ Insl~ ction Services
P.O. Box 1130
Oshlcosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applica~iom will not be processed.
· Applioation(s) alld fee(s) call b~ brought to City Hall, Room 205 or mailed to Inspection S~vices, PO Box 1128,
Oshkosh WI 54903-I 128. Coiihi~noin8 work without permit(s) will result in fe~s boirig doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
[~i_Y'ou ar~.a contr_~ctor participating tn the Permit fee ,~ccount System and have bdequate fun, ds, check.here
if ~ou want ii, is processed through your account ~
CHI~CK [~ ALL APPLICABLE
USE CATEGORY
Ii]Single Family ElDuplex
EIMulti-Family ClRental
ElCommercial
IzUEL llilOas ['lElectric [2Solid SYSTEM ElNcw
E]Oil D$olar 12Other
~orced Air ElRadlant EISt~am EIMC ElVent EIEIectxic DHot Wafer [2Suppl.
I$ CHIMI~Y BEING LINED, [~o IZIYes - LINER SIZE. & MANUFACTUP~R
CHIMNEY TYPE CIGhinm~y A ElChirrmey B l~irect Vent OOther
WE. AT LOSS CIAs Approved [~t~xisting [3N~ot Applicable., ~
BTU RATE
D£$CRIPTION.OF AI4L WORK BEING DONE
~"eplace
EICon. Burner
VALLr~ (Including lalMr and all materials including light fixtures) ~ [ 0'O, O'~ ~
~ For appli~ble ~ojec~, ~ Elec~c ~s~llation V~fication fo~, si~ed by ~c Elec~cal Con~or, m~t be
at~ched. If not a~ched or ~ot applicable, a separate Elec~cal P~it is ~qu~d.
~102
FROM :TENTH STREET STATION, INC.
FAX NO.
Cay z~
PO Box ! 130
O~hL'o~'WI $4903-H30
Office 920-336-50,50
:920-27,6-0150
May. 09 21~3 12:2TPM P2
Electric Installation Verification
.' ; . ' ' (El~trical Contractor Name)
· ' . (Aa~b (City) ' (State) (Zip Code) '
haVc',b~n ~on~c,~d to p~fo~ ~l~c,~c imtaHafion work fO~~ ~~ ~.~ ,'
,. . . ~e ofp~y cOn~acted to)
(Address w. hem work' ~1~ be p~fonned)
' Tho nature of~ W~k' consists o~ (~eck ~c m Describe ~e Na~, of Work)
~ ~0~fion or n~ cimuit for ~eplacment Electric Wat~ I{e~ or pow~ vmted
.: .... ReCo~tion of the Semice En~m~c, Cable; Met~ Box, ~te~o~ to r~aci~
' ' ~d li~g ~tu~ ~e to si~ng / soffit Ma~on. Note: Now S~ce
"... :. En~e Cabl~ ~B ~uir¢ a sep~a¢ permit.
,. ... . R<o~ec~on or n~ circuit for ~e replacem~t'ofo~ p~tly
'." ~ New ckcuit for the addition of ~C to ~ ;~d[~;.dual dwelling Unit ~ome or
in~vidu~ s~s in a duplex or ~adomiMm), ~clu~ng ~ s~i~
I h~oby veri~ ~s work ~11 be p~o]med by ~ ~plo~e.of~iS comply ~ ~er v~
the reco~o~ion / ~st~lation will be done M compli~ce ~ m~ufac~ ~d Elecffic ~de
requirmen~, ' .
... . ~c~) ~rint Name of Office0 .... ..... (DOte)