HomeMy WebLinkAbout0098660-HVAC (boiler) 0 CITY OF OSHKOSH No 98660
CA/y
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD �A'l
o
ON THE WATER
-1TE
Job Address 1014 MORELAND ST Owner GARY L DAVIS Create Date 11/15/200
Contractor STEINBRUNER HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas Oil I Electric Solar I Solid
System n New 1 0 Replace 0 Other
Li Forced Air U Radiant U Steam U A/C u Vent
Electric 11 Hot Water. Suppl. Con. Burner
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss G As Approved • Existing 0 Not Applicable Value 0
BTU Rate ) As Per Plan n Variable • Other Value
Use /Nature SFR/ Replace boiler. *EIV form from Seckar Electric.
of Work
Fees: Valuation $2,500.00 Plan Approval $0.00 Permit Fee Paid $42.50
Issued By: Date 11/15/2002
❑ Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 - 0 Telephone Number (920) 426 -1830
11/14/2002 21:55 19204261890 STEINBRUNER FEATING: PAGE 01
0 Gty of Ostilcosh I �
GA.
Division of Inspection Serves :41' .i, \'
P.O. Box 1130 `pp,J
Oshkosh. WI 54903 -1130 12D ,
Mcrae (420) 236 -5050
Pail (920)236 -5084 , H H
ON rus WA
! HVAC PERMIT APPLICATION
All information after bold categories must be provided,
Incomplete applications will not be processed.
• Application(s) and fe:(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 - ,128. Commencing work without permits) will result in fees being doubled or 5100.00 plus the
normal permit fee, which ever is greater.
OR I
'a_ , re a t n r t t r • art, i , atin 'n the Permit . coon 1 and lave ad , uote un • s h k here
• •ou w- t this .ro d i rtu!h o. • _ tt ►'I
DATE b -IT-0 Z
JOB ADDRESS to j I t4-14 J-c I--
OWNER itk/L1 014/40
•
CONTRACTOR 5 ■ • a . , 4 • _ u lit r
CHECK IN ALL APPLICABLE I
1
Alt CATEGORY
. ingle Family LiDuplex Multi-Family DRental OComrr ercial °Industrial
i
FUEL C3E4as ' ❑Electric DSolid SYSTEM ONew Q'Replace
DOiI DSolar ;' DOthe'
TYPE
DForced Air DRadiant Steam OA/C OVent DElectrie Hot Water DSuppLDC3n. Burner
IS CHIMNEY BEING'LINED No DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented. •
CHIMNEY TYPE Ifiebimney A " DChimney 13 ODirect Vent DOther
HEAT LOSS DAs Approved Ousting DNot Applicable
BTU RATE .DAs Per Plan OVariable DOther Value C. Li 3 5 /00-) 1341 t it' r
.
r
DESCRIPTION OF L WORK BEING DONE PLpLg ILA/ ima-fe
VALUE (Including labor and all materials including light fixtures) $ 0 5
ELECTRICAL CONTRACTOR S.cr.0 r'' _Oa X.E ectric Installation Verification form attached(If Replacement)
Electrical tn,nallnuion ujneWrivinet meat equipment shell be done by lieetued rontenctun.
3/02
._
11/14/2002 21:55 19204261890 STEINBRUtER HEATING: PAGE 02
o . 5
cit Oshkosh
rovisi of hssootoon Servic
215 11 Meow
PO ■tuo
w1
54902-1150
920.230d
ow Tool wrta FIR 236.50$
A
Electric Installation Verification
(t) (We) $ 2etT 1
(Electrical Contractor Name)
g 1 Zo , Cou ppua rw,i.kt a rep 0iN�Ecow� e-
( Address) (City) (State) (Zip Code)
have been contracted Ito perform electric installation work for STr /N tiAiek.
(Name of pal ty contracted to)
at the following addreiss: ID 1 q j/k.-/pi. •
(Address where work will be performed)
The nature of the wo k consists of : (Check One or Describe the Nature of Work)
R connection or new circuit for replacement Heating Plar t and/or A/C Condenser.
R connection or new circuit for replacement Electric Waller Heater.
R connection of the Service Entrance Cable, Meter Box, alterations to receptacV s and
lighting fixtures due to siding / soffit installation. Noi e: New Service Entrance
1 Cables will require a separate permit.
R connection or new circuit for other permanently wired appliances / fixtures.
er
The value of this vork is
I hereby verify th s work will be performed by an employee of this company and further verify the
reconnection / in tallation will be done in compliance with manufacturer and Electric code
requirements.
iyt tel. e .__ _ Se-A R t( 14 o
(Signaturc • Co ipany Officer) (Punt Name of Officer) (Da c)