HomeMy WebLinkAbout0101718-HVAC (a/c)OSHKOSH
ON THE WATER
,Job Address 1559 GEORGIA ST
Contractor TENTH STREET STATION INC
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner PAUL A/CONNIE S DEXLER
Category 501 - Residential-Air Conditioning
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101718
05/22/2003
Other
Vent J
2 ton
Use/Nature SFR/Replace 2 ton A/C. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$1,400.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$26.00
Date 05/22/2003
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, INC, FAX NO. :920-236-0150 Maw. 22 2003 07:3SAM P1
City of Oshkosh
. Division of Inspection Services
P-O. Box 1130
Oshkosh, WI 54903-1130
Phone .(920) 236-5050
Fax (920) 236-508~
HVAC PERMIT APPLICATION
All information after bold categories must be provided,
!ncomplete applications will not be processed.
HKO/H
· .Applicati0n(s) and fee(s) can'be brought to.City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fen being doubled or $100.00 plus thc
normal permit fee, which ever is gre, ater.
OR
.If yOU are a contractor participating in the ..Permit fee Account Swrem _and have hdeauar¢ f~.ttds, check he~r_e
if.you want this r~rocessed t~b.~ough your account
A D SS /5
CHECK Iii ALL APPLICABLE
USE CATEGORY
~ingle Family ElDuplex CIMulti-Family
OOil OSolar
ElForced Air I-IRadiant ElSteam ~I~A/C
ElRental OCommercial
SYSTEM ~New
OV~nt ClEtectnc Elliot Wa~tn-
IS CHIMNg¥ BEING LINED []~[o ElYes - LINER SIZE
Note: All ch/rtltlcy$ shall be sized per ting BTU'$ being vented.
~AT LOSS ~As A~roved ~xisting
BTU ~ ~As P~ P]~ ~V~iable
OIudUs~al
~ep]ace
ElSuppl. EICon. Burner
& MA3RIFA~R
E]Dircct Vent l!~Other
['lNot Applicable
ElOther Value ~ e/'e~j
VALUE (Including labor and all =aterials including lil~ht fixIures) $/~/~Ot~) - t/*O ~' ~.~.O0
~LV. CrmcA~ CONTitnCrOa _~/~e3(l~
[Y~or applicabl~ projects, an Eleetrlc Installation Verification form,.signed by the Electrical .Contractor, must be
attached. If not attached or no! applicable, a separate Electrical Permit is required
. KROI'I~:TENTH STREET STATION, INC. FAX NO. :920-23B-0150 Hay. 22 2003 07:~M P2
Electric Installation Verification
(Elm~c~d Concca~tor Nanle)
~ ~) (State) (Zip
haw ~sn ~~ m ~rfo~ ~c ~]~do~ work f~~+~ ~~ ~-~
(~s~ ~ wm-k will b~ p~o~)
~ ~~ ora. c~t ~o,' rcplac~, ~ng
o~ or new cim~t f~ r~laoement Altec Wat~ Heat~ ~ ~ vmtted
wat~ heat~.
R~cormection of the Service P-a. thrace Cable, Meter l~os, alterations to re~-ptacl~s
Entrance Cables will require a s~atc permit:
Reconncction or new ~irouit £or
~ptlancea / fixtures, ~ replacement of othe~ penn~ently wimcl
New t~ircnit for the addition of:A/C to an ~vld~l gwelltsg u~r (house or the
individual systems in ·
eloctrical outlets, a duplex or ¢o~lovmnlum), including r~uimd sm'vi~
ThcvMuc ofthi~ work is $ /g~:~ '---
! hereby v~ tMs work will be performed by an wnploy~ o/'thls company Ired fi2rther verify
the recolniecfion / ~u~tall~tion will bc done ~ compliimcc with manufacturer and Electric code
requtrcments.