HomeMy WebLinkAbout0099100-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
332 W 6TH AVE
STEINBRUNER HEATING & COOLING
No
99100
L~] Gas I
J-']New
L~ Forced Air J
~j Electric J
ChimneY Type ~ Chimney A
Heat Loss ~ As Approved
BTU Rate ~) As Per Plan
~J Oil
L-J Radiant
~ Hot Water
Chimney B
~ll Existing
(.,.) Variable
Owner ROBERT D HERTZBERG = Create Date 12/16/2002
category 500 - Residential-Heating & Ventilating Plan
~ Electric J L] Solar J L~ Solid J
[] Replace J [] Other
j_d Steam j L---J Nc J L-J vent
~ Suppl. j ~ Con. Burner I
Direct Vent ~ Not Applicable J
~ Not Applicable J , Value
~I Other J Value
70m btu
Use/Nature DUPLEX/Replace fumace- cracked. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$35.00
Date 12/16/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 -0
Telephone Number '
(920) 426-1830
. i2/i5/2002 2i:40 i92o426189o STEINBRUNER HEATING: PAGE 02
City of Oshkosh
Division of Inspection
P.O. Box ! 130
Oddcosh~ Wt 54903-1130
~ (920) 23~50~0
~x (920) 236-5084
normal permit tee,
OR
lf_~,ot~ o. rt, a con~racto
ADDRESS__
¢O T CTO
HVAC PERMIT APPLICATION
.MI information after bold categories must be provide~
Incomptete applications will not be processed.
~ ' Hall, Room 205 or mailed to Ins
· Application(s) and fee(s) can be brought to C~y
Oshkosh WI $4903~] 128. Commencing work without permit(s) will result in re
hlch ever is greater.
r t)articipatitte in the permit fee d..ccount System and
'sed thro.~gh your ttcc unt~~
DA
CHECK [] ALL APPI'ICABLE
USE CATEGORY
l~Singl¢ Family ~uplex I~Multi-Family CIRental I3Com~ :~rcial
I
FUEL [~a~ C]Electnc I-ISolid SYSTEM C]Ne~
ViOil ] l~Solar
~orced Air I'lRadianltC3Steam FIA/C ~Vent [~Electric ~Hot Water i-]Suppl.~(
ection Services. PO Box 1128,
~s being doubled or $100.00 plus the
~ave ade~luate.fund;, check herr
on. Burner
:ACTURER
Note: All chi..~eys shall ~e sized per the BTU's being vented,
/
ClllMNEY TYPE | i~himney A VIChimney B
ffEAT LOSS !VIAs Approved IBL~'xisiing
BTU RATE :V lAs Per Plan EIVariable
l-IDirect Vent
CINot Applicable
vIOther Value
rql )ther
DESCRIPTION OFA~LWORKBEINGDONE_.~'. "'ee~- -~o~e.~--
VALUE (IncJuding labor and all materials including light fixtures)
$
I~.i.ECTRICAL CON4RACTOR ~--c~a_r~ O._~R ~Eleelrk lns~illtflo~ Ye
Electrical in.~tallation of new/rept~c~
ificatioa form at~aehedUf Reolacemem)
neat equipment ~Aoll be done by licensed contrnelor~.
Olndustrial
~r~'~place
12/15/2882 21:48 19204261890
STEINB~UNER HEATING:
PAGE 03
(I) (we)
Electric Installation Verification
(Elecuical Contractor N~ne)
(Address) '. (City)
have been contracted %o perform electric installation work for
(State
(Name of pa:
at lbo following address: ~'2. /O ~
(Address where work will ~ perfo~
Tbs azure of thc xvo~ consists of: (Check One or Describe the Nature of~
~ Re~o~ection or new circuit for replacement H~ting
Plat
ReConnection or new circuit for replacement Electric War
Re~onnection of the Se~ice Entr~ce Cable, Meter Box, ~
' lighiing fixtures due to siding / soffit installation. Not,
~ Cables will require a separate pem~it.
Re~o~ection or new ci~uit for other pemmncntly wired
O~er
The value of this {york is $ .
! hereby verify thi~ work will be performed by an employee ofthis comp~
reconnection / installation w~ll be done h~ compi~m~ce wi~h m:mufac[ure~
requirements.
·
___ !. [~ ~ er (Phnl of OffiCer)
(Si~mturc ~ C~mpany Offic ) Name
(Zip Code)
:,cOWerS...
contracted to)
ned)
fork)
I and/or AfC Condenser.
:r Heater.
Iterations to ,'eccptacles and
;: New Service Entrance
ppliances / fixtures.
ny and further verify the
and Electric code
(Date)