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HomeMy WebLinkAbout0101435-HVAC (a/c)(~ CITY OF OSHKOSH OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 150 W 22ND AVE Owner JAMES M/SUZAN E MEYER Contractor TENTH STREET STATION INC Category 501 - Residential-Air Conditioning Fuel ~J Gas J ~J Oil L~J 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 ~ Direct Vent O Not Applicable I Heat Loss I~ As Approved ~ Existing O Not Applicable I Value BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 2.5 ton a/c No Create Date Plan ~J Solid Vent 101435 05/13/2003 Use/Nature SFR/Replace a/c and add ductwork. of Work Fees: Valuation Issued By: $2,700.00 Plan Approval $0.00 Permit Fee Paid Permit Voided $45.50 Date 05/13/2003 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 , .FRO~ :TENTH STREET STATION, INC. FAX NO. :920-236-0150 Mag. 13 2{~3 08:32AM P2 City of Oshkosh · Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-$050 Fax (920) 236-5084 OffH HVAC PERMIT APPLICATION All izfforrt~lion after bold categories must be provided. Incomplcts applications will not be processed. · Application(s) and f~(s) can b~ brought to City Hall, Room 205 or maflect ~o Inspection Sa, vices, PO Box ! 128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees b~g doubled or $100.00 plus the normal permit fcc, which ewr is greater. OR If vou are a contractor particinati~ in the Permit _fee Account System a~d have ~deqFate fund$~ check her_e if y(~u want thi~ ptocex$ed through your account [~ CI~-CK ~ ALL APPLICABLE USE CATEGORY I~Single Family ClDuplex l'3Multi-Family ClRental OCommetcial IZlIndustrial FUEL OC.~ l~Blectric I=lSolid r-lOll OSolar TYPE' OForced Air ElRadiant F'lStcam ~A/C [3Vent SYSTEM [3Electric ElNew IgReplace OOther ClHo~Wa~er OSuppl. EICon. Burner IS L3UMNEY BEING LINEI}~No O,Y,~s - LINER SIZE Note: All chimneys shall be sized per ~e BTU s being ventcd, CIIlMNEY TYPE OChimney A EIChimney B HEAT LOSS CAs Approved ElExisting BTU RATE I-lAm Per Plan OVariable DESCRIPTION OF ALL WORK BEING DONE & MANUleACTURER~ [3Direct Vent ~Not Applicabl~ VALU~ (Imelnding labor nnd all materials including light fixtures) $ 2. 700. cc: ¢o r Ct CAr E1 For applicable projects, at'Electric Installation Verification form, signed by the Elec~ical Contractor, must attached. If not attached or not applicable, a separate Electrical Permit is required.