HomeMy WebLinkAbout0098870-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
610 W GRUENWALD AVE
STEINBRUNER HEATING & COOLING
L~J Gas I [] Oil
[] New I
L-J Forced Air I LJ Radiant
[] Electric ] [] Hot Water
Chimney Type O ChimneyA ~ Chimney B
Heat Loss ~.~ As Approved ~1 Existing
BTU Rate ~ As Per Plan ~ Variable
Owner GLEN M/PATRICIA NICHOLS
Category 500 - Residential-Heating & Ventilating
[] Electric I [] Solar
[] Replace I
L--J steam j ~J NC
[~uppl. ] L~ Con. Burner
(.~ Direct Vent (..~ Not Applicable j
~ Not Applicable t Value
~11 Other I Value
No 98870
Create Date 12/02/2002
Plan
[] Solid ]
[] Other j
L-J Vent J
Use/Nature
of Work
~FR/
Replace boiler. *EIV form from Seckar Electric.
Fees: Valuation
Issued By: ~-~V~
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$35.00
Date 12/02/2002
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
12/02/2002 02:09 19204261890 STEINBRUNER HEATING: PAGE 01
· Civ/of Oshkosh
Division of Inspection Scr~
I~.O. Box l 130
O~b,kosh, wi 54903.1130
lq~me (920) 236-5050
FaX (920) 2.t6.5084
'o
HVAC PERMIT APPLICATION
All informaoon after bold categories must be provtde~
Incomplt~e applications will not be processed,
Application(s) and ldo(s) can be brought to City Hall, Room 205 or mailed to ln.q
Oshkosh WI 54903-~1128. Commencing work without permit(s) will result in
normal permit fcc, w~ich ever is greater.
OR
/
If Vou are a contragro~ partt~.ipa!ing in the Permit_fee Acc_~o,tnt Sv,~tem and
fl you want this processed thr(~u~h your ac£ounf t~],
JOB ADDRESS
~R
L'ONTRACTOR
~IECK [] ALL APPLI
CATEGORY
l~rS~gle Family 131
CABLE
)uplcx ~Muhi-Family ~Rental ~Comm~
~as OElecmc ~5olid SYSTEM ~New
~L
~ced Air ~Radiant ~S~eam ~A/C ~Vent ~Elecm~ot Water ~SuppI.OCo
~NEY BEING t I~D ~No ~Yes ~ L~ER SIZE ~O & MA~E
All chi~eys shah be i~ed p~ the BTU's being vetoed.
~M~Y T~E ~ ~ey A ~Chi~ey B D Direct Vent
~AT LOSS C fas Approved ~ing ~Not Applicable
~ ~Other Value
r':lAs Per Plan OVariable
WORK BEING DONE..
i~SCRIPTION OF AL1
~'ALUE (Including labor
' ~'LECTRICAL CONTI~
OYk O/H
ection Services, PO Box 1128,
s being doubled or $100.00 plus the
md all materials including light fixtures) $ ~) tTOO nC
ACTOR~..~~ OR ~ff~£1eetric Insllilation V~lf
Eh~tric~l in,~talloti~ O~w/~plnCeme
i,ave adequate.funds, check hCye
rcial r'llndustrial
~..place
B um~r
CTURER
~er
:atlOn form allached{lf Replaccrnentl
ri Cq~q~lWettt shall be done by liren~ett COntractors.
~/0~
12/82/2882 02:89
19284261898
STEINBRUNER HEAT] NG:
PAGE 82
POI~
OIFm
(we)
(Address)
have been contracted
at the following addr~:ss:
mef Im~¢l~oo
4h WI S,i~)2-1 t ~o
~2~..2~6~SGSO
D,2't S. SQ84
Electric Installation Verification
(Electrical ContractOr Name)
(City) (Stat(
to perform electric installation work for ~_ ~ [~/,
(Name ofp~
(Address where work will bc perfo'
Re
k consists of' (Check O,e or Describe the Nature of'
:ormection or new circuit for replacement Heating pla,
~conneCtion or new circuit for replacement Electric Wal
:connection of the Service Entrance Cable, Meter Box,
lighting fixtures due to siding / soffit installation. No
Cables will require a separate pemfit.
R~connection or new circuit for other pemmnently wired
her
work is $ I L0~
is work will be performed by an employee of this eon'q:.
;tallation will be done in compliance" with manufacturcl
(Zip Code)
contracted to)
/gork)
an,t/or A/C Condenser.
er Heater.
~lterations to receptacles and
:e: New Servic~ Entrance
appliances / fixtures.
The value of this
I hereby verify th
reconnection / in:
requirements.
~ignaturc o~' Co~npany Officer)
any and further veri fy the
· and Electric code
(Print Nat'nc of Officer'