HomeMy WebLinkAbout2003-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 1337 WASHINGTON AVE
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 GLADYS T HARVEY
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 ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102673
07/07/2003
Other
Vent J
2 ton
Use/Nature SFR/Install new 2 ton A/C with ductwork. *EIV form from Drexler Electric.
of Work
Fees: Valuation
Issued By:
$3,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$63.50
Date 07/07/2003
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. :920-2~6-0150 Jul. 07 L:~)03 10:88AM P1
City of Oshkosh
Division of Iml~¢tion Servi~s
P.O. Box 1130
Oshkosh, WI :54903- I 130
Phone (920) 236-5050
l%x (920) 236-5084
O/HKO/H
HVAC PERMIT APPLICATION
All 'w. formation after bold catcgolics must be provided.
Incompleie applications will not be processed.
Application(s) and fe~(s) can be brought to City Hall, Room 205 or mailed to Inspection s~rv~ces, PO Box 1128,
Oshkosh WI 5a903-112g. Commencing work without permk(s) w~ll result in fees being doubled or $100.00 plus the
norra~l permit fee, which eve~ is greatest.
OR
lf v~u are a contractor participating in the Permit~ee ,4ecount System and have hdeeuate funds, check her~
i£ gOu Wan~ this nrocessed throueh your account ~]
CHECK I/! ALL APPLICABLE
USE CATEGORY
~Single Family 13Duplex
r'lMuhi-Family [ZlRontal I-IConmaercial ullndustfial
FLrEL I'lGas [:~Elec~ic I-1Solid SYSTEM r~Ncw
~ForcedAir ~di~t OSt~ ~C OVent OElec~c
IS C~Y BErG L~D ~o ~Y~s - L~R S~E~
Note: All c~e~ shall b~ ~ per ~ B~'s berg vetoed.
~AT LOSS O~ A~roved OExisfing ~Not Applicable
B~ ~ ~As P~ ~ aVanable ~Om~ V~ ~
OHot Wafer I'lSuppl.
MANUFACTURER
I~Replaee
r'lCon. Burner
' VALUE (lneludlng lair and ~1 materials includl.g Ii§Ut Oxtu~s) ~., /~f~f~- ~
~For applicable projects, an ~]e~W/c ln$lallafion Verification form, signed by the Electrical Con~'actor, mu~t be
attached. If not attached or no~ applicable, a separat~ FI¢clrical permit is requix~d.
. FROM :TENTH STREET STATION, INC.
FAX NO.
:g20-2~6-0150
Jul. 0?2003 10:09AM P2
Electric Installation Verification
('Electrical Contractor Name) ~--~'--'----~
(AddresS;) :' -- ~ (City) -- (State) "(Zip Code)
following ad~e~: I 3 B ~ ~[ ~.~.~e of pray coa~aet~ ~),
¢~ss wh~e work
of~e work eomists'of: (Ch~k One ~ D~b~ ~e Na~e of w°
R~°rmecfion or new circuit for replae,m~t ~g Pl~t ~°I ~C Conde~er.
R~o~eeaoa ~ n~ c~rcmt for ~lac~ent Elee~e Wat~ Heater or ~wer vent~
w~ heater.
Rec°meefi°n °f ~° Se~ice En~m~eo Cable, Met~ Box, ~temtiOns to r~taeles
~d ~gh~g fixmr~ due to siding / soffit ~all~oa. Note: New
'. ~ee Cables will require a s~am, pe~it. .
R~o~ecfion or n~ cim~t for the r~lacem~t of o~ pem~ently ~r~
New ckcuit for ~e a~iff°n of~C to m~ individualdwelling unit ~ouse or
~hd~ s~ems ~ a d~lex or condo~), includi~ r~uired ~e~ce
el~c~ outlets.
0~er
. . . .' The value ofthis work is $ ' ~:~.
: ' · ~,hereby verify this work will be ~,erlB,-,,--a u ..... _ . . ' '
me reconn~ctmn / installation will be done/n c,,,,~,,,,,~2 ~.e.¢.?,_~ thru COmpany and further verif
".. ' requirements. ~,~,-*~.~ yom manulacturer and Electric cod7