HomeMy WebLinkAbout0102394 HOSHKOSH
ON THE WATER
.lob Address 1608 NORTHPOINT ST
Contractor TENTH STREET STATION INC
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 GEORGE/DOROTHY HASZEL R TRUST
Category 501 - Residential-Air Conditioning
Electric
Replace
L~ Steam
L~ 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
102394
06/24/2003
Other J
Vent J
3 ton
Use/Nature SFR/Replace 3 ton A/C. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$1,600.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$29.00
Date 06/24/2003
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
]ucom]~Icte apphCat~ons ~ttl not be p~eSSUU
'" ' ' or ~ilcd to ~ec~on S~ccs, PO ~x 1128,
. Appli~on(s) ~d fee(s) ~ ~ ~ou~t to CiW HaH, Room 205 . .
Os~h ~ 54~3-112~. Co~c~ w~k wi~out p~t(s) ~11 ms~t m f~s ~ doubl~ ~ $100.00 pl~
n~l ~t f~, w~ch c~r is ~ter,
' CitKCK ~ ALL APPLICABLE
USE CATEGORY
~$ingle.F~mily DDuplex
FIMulti-Family DRental E]Commercial I-IInduStrial
FUEL ~Oas' ~Electric {-{Solid
DOll , E]Solar
SYSTEM DNew [~rReplace
t-lOther
T?t~PE
OForced Air ClRadiant ElSte~m [~C E]Vent E]Electfic
IS CFiIMNE¥ BEING LII~D/I~No FIYes - LINER SIZE
Note: All chh'g~ys shall bc sized per the BTU's b~ing vented.
DHot Water I2]Suppl,
& MANUFACTUR.ER
12lCon. Burner
CHIMNEY TYPE C1Chimney A ~Chimney B []Direct Vent ll}~ther
HEAT LOSS Y'iAs Approved ~Existing C]Not Applicable
BTU RATX EIAs Per Plan ~Variable DOther Value
' V~LUE (lucludiuz hbor and all materials i.eluding light fixtures) $//~) ° (/Z~
ELZCTIUCAL CONTRACTOR ~.~
~ For applicable projects, an Ele¢lrie Installation Verification form, signed by the Electrical Cona'aetor, must be
attached. If not attached or not applicable, a separate ElectrieaI Permit is required.
~ FROMm:TENTH STREET STATION, INC.
FAX NO. :g~0-~6-01~0
Jun. 24 2003 09:llAM P2
C)./HKOj~H
Gee)
:' Electric Installation' Verification.
(Electrical Contractor Name).
(zip Code)
(City) (State)
.. (Name of party cont~acted to)
" (Address. where wo.;k will be.performed)
The nature 0fthe work consists of.', (.Check One or Describe the Nature of'Work)
,,~ Keconne~fion or new circuit for rePlacement Heating Plant and/or AJC Condenser.
.. _ Reconnection or new circuit for replacement Electric Water Heater or'power vented
'- ' water heater. . ·
Reconnection of the Service Entrmice Cable, Meter Box, alterations to recePtacles
and lighting fixtttrea due to siding / soffit installation. Note: NewService
Entrance Cables will require a separate penni/. '. ' ....
Recolmection or new circuit for the replacement of other permanentl .y,?imd
· .app!iacces / fixtures.. ' .... ,- ..? .......... .
"' New circuit for file addition of A/C to an individual dwelling unit'(house oi' thc
individual systems in a duplex or condominium), including required service
·. electrical outlets.
Other '. '
The value of this work'is $. ~r.-gT'~ ' ': "
':' '. '.'I hereby ~,crlfy'thi~ work will bc'p~fonned by an employee of this company and fisCher'verify' ' ...
.: the recormection / installation will be done in compliance with manufacturer and Eiectric code '
requirements..
,. mpany Offiger)''' PI4~, I_C j p D, ~/::k
O r it Nam, or Ofac )