HomeMy WebLinkAbout0102023 HOSHKOSH
ON THE WATER
.lob Address 1663 MICHIGAN ST
Contractor ADONIS HEATING AND COOLING
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 STEPHEN R/SANDR SPENCE
Category 502- Residential-Both
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
102023
06/06/2003
Other
Vent J
Use/Nature
of Work
Building will be converted to a single family residence.
Fees: Valuation
Issued By:
$4,800.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$77.00
Date 06/06/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W2707 County Rd H Pine River WI 54965 -0
Telephone Number
685-0458
OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature IFR/
of Work
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1663 MICHIGAN ST Owner STEPHEN R/SANDR SPENCE
ADONIS HEATING AND COOLING Category 502- Residential-Both
b~J Gas I L~ Oil I [J Electric I [] Solar 1
[] New I [] Replace J [] Other
~J Forced Air ] ~ Radiant I L~ steam I [~ NC 1
LJ Electric I [~ HotWater I LJ Suppl. I ~-Con. Burner I
~ Chimney A ~.~ Chimney B ~l Direct Vent ¢_~ Not Applicable I
~ As Approved ~.~ Existing ~1~ Not Applicable I Value
~ As Per Plan F_~ Variable O Other I Value
Building will be converted to a single family residence.
No 102023
Create Date 06/06/2003
Plan
[~ Solid
I__1 Vent
Fees: Valuation $4,800.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
In the performance ~o/f.~fs work., ~"~e/tJpe+ ~,,les governing the deScribed construction.
Signature
Address
$77.00
Date 06/06/2003
County Rd H
Pine River
WI 54965 - 0
Telephone Number 685-0458
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(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 fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I£¥ou are a contractor participating in the Permit fee Account System and have adequate _funds, .check here
i£¥ou want this processed through your account ['~
DATE
CHECK [] ALL APPLICABLE
3
USE CATEGORY
~jngle Family F1Duplex
12Multi-Family
V1Rental
V1Commercial
Vllndustrial
FUEL .,~tG-as IDElectric V1Solid SYSTEM FlNew
F1Oil VISolar F1Other
FIReplace
TYPE
;:t~Forced Air V1Radiant [2]Steam J~.A/C F1Vent FIElectric [2Hot water [2Suppl.
IS CItlMNEY BEING LINED VINo 123Y~ - LINER SIZE & MANUFACTURER
Note: All chinmeys shall be sized per the BTU's being vented.
FICon. Burner
CHIMNEY TYPE
HEAT LOSS
BTU RATE
[2Chimney A
V1As Approved
V1As Per Plan
V1Chimney B
[2Existing
V1Variable
~D~rectVent
U1NotApplicable
12Other Value
F'lOther
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures)
ELECTRICAL CONTRACTOR ~c_._ ~ O,C-
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
O/HKO/H
ON THE WATER
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-] 130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(Electrical Contractor Name)
(Address) (City) (State)
have been contracted to perform electric installation work for /ftC/9/v ! ~ ~,/fTD/V ~
(Name of party contracted to)
at the following address: //~ ~9 ~ fi,/1 (CPI( 6 ~ ST--.
(Address where work will be performed)
(,dr
(Zip Code)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ ~ O. ~ G
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Si mpany Officer)
(Print Name of Officer) (Date)
5/O2