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HomeMy WebLinkAbout0101882 HOSHKOSH ON THE WATER .lob Address 667 N MAIN ST Contractor MARX MECHANICAL LLC Fuel System Gas J ~J Oil New ~ CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Forced Air I ~J Radiant Electric I ~J Hot Water Owner BETTY JEAN FINK ETAL Category 501 - Residential-Air Conditioning L~ Electric Replace L~ Steam L~ suppl. Solar A/C Con. Burner Chimney Type I~ ChimneyA ~ Chimney B Heat Loss I~ As Approved ~ Existing BTU Rate I~ As Per Plan ~ Variable Direct Vent Not Applicable Not Applicable Other Value Value No Create Date Plan L~ Solid 101882 05/30/2003 Other Vent J Use/Nature COMM/Replace rooftop HVAC unit with Lennox GCS16-060-120-4P unit. *EIV form from Hoehne Electric. of Work Fees: Valuation Issued By: $5,000.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $80.00 Date 06/02/2003 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number (920) 235-6510 Division of Inspection Services P.O. Box 1130 .... Oskkoshl Wl 54903'[ 1] 30 Phone (920) 236-5050 FaX (9"20) 236-5084 -~ RECEIVED MAY 5 0 200J DEPARTMENT OF HVAC P E Rfi~ ~[~T~ ~~ENT Alt information after bold categories must be provided. incomplete applications will not be prgcessed. ON THF WATER · Application(s) and fee(s) can be brought to City Hall, Room 205 or ma/led to Inspect/on Services, PO Box t t28~ Ost~osh WI 54903-1128. Conmaencing work w/thou/permit(s) will result m fees being doubled or $100.00 plus the no~al pe~t fee, which ever is ~eater. ]f you are a co;,tractor participatin~ in the Permit fee Accou;~t Syslem a;,d have adequate funds, check here if FOU WallI this processed Ihrough Four account ~ CONTRACTOR CHECK [~/~LI. A]BPLICABLE ' USE CATEGORY t--ISingle Fmnily lDDUpleX ' l-tMutti-Family l-IRental ~Commercial Ullndustfial FUEL ~GaS FqElectfic E]Sotid SYSTEM F1New ]~Reptace lDOil U]Sotar l-lOther TYPE IDForced Air l-lRadim~t E]Steam I~IA/C ~Vent ~Electfic E]Hot Water ~Suppt. [~Con. Burner IS CItlMN~EY BEING LlhrgD DNo IDYes - LINER SIZE Note: All clfinmeys shall be sized per the BTU's being vented. & MANUFACTURER CItJ=M2hrJEY I{EAT LOSS BTU RATE ~Chinmey A t-lAs Approved ~As Per Plan El Chin~ey B I-]Existing IDVariable [--1Direct Vent I-tNot Applicable t-qOther Value iZlOther DESCRIPTION OF ALL WORI{ BEING DONE ~A~uE (in~[u3i,;g labor and all materials including light fixtures) $ ~000_ ,0) . . ~ For applicable prdects, an Electric Installation Veribcafion lorn% s/~xed by t]~e Elcctzica] C'ontractor, must be attached. If not attached or n~t app]icab]% a separate E]ecSica] Pm'mit is mqufl'ed. s/o2 Electric Installation Verification (Electrical Contractor Name) (City) ( have been contracted to perfonm electric installation work for at the foltcwing &ddress: 667 N Maim St Thc nature of th~ work consists of: (Zip Code) Crosby Dance Studio (Name of party contacted to) (Ad.ess where work wil] be p~ffoxm~) (Check One or D oscribe the Nature of Work) RecoImection or new circuit for rvpheeraent Heat~g Plant ~Wor MC Condenser, Re~mn~tion or new circuit for r~lzcem~t Elec~c Water Heater or power vmtcfl wat~ Reco~tion oflhe Se~icc Entrance Cable, Memr Box, aheralions to receptacles ~d lighting fixtures duc lo siding / soffit hmtallaSen. Note: New Service Entrance Cables will require a sep~ate pemit. Reeonneeti on or new eirc~t for the replaemem ofmhez pemanently wired applimces / fixtures. Ne~ circui! for ~e a~ition cftc lo ~ inaiviguaI dwelling unit (h~use individual s~tems in a duplex or condami~im), including required el~eml outlets. Other The value oflhis work is I hereby verify this work will be pcrfbrmod by an employee of this company and f~rthcr verify zhc reconnecti~n t inaallation will be done in eompliance with m,mufae~u:'er m..I Electric code req uir em cn ts, - (~;~a u, ~ o~ Co~.pany Officer) (Print Name of Offic~r)