HomeMy WebLinkAbout0099019-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY. OF :OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
251 N MEADOW ST
STEINBRUNER HEATING & COOLING
No
99019
L~J Gas I LJ Oil
[] New !
L~J Forced Air I LJ Radiant
LJ Electric I LJ Hot Water
Chimney Type ~t Chimney A (.~ Chimney B
Heat Loss [~) As Approved O Existing
BTU Rate ~.~ As Per Plan (.~ Variable
Owner MARILYN J GERRARD
Category 500 - Residential-Heating & Ventilating
L~ Electric I ~ Solar
[] Repla_ce ....... ~
LJ Steam j [~ NC I
½ suppl. I LJ con. Burner I
~ Direct Vent (...) Not Applicable I
(.~ Not Applicable Value
O Other Value 60,000 btu
Create Date 12/10/2002
Plan
LJ Solid
E~_ Other
Vent
Use/Nature SFR/Repalce furnace* EIV from Seckar attached
of Work
Fees: Valuation
Issued By: ~/~"/
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided I
$35.00
Date 12/10/2002
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
STEINBRUNER HEATING:
i
HVAC PERMIT APPLICATION
All information after bold categories must be provide
Incomplete applications will not be ~ocessed.
Application(s) and fe!(s) can be brought to City Hall, Room 205 or mailed to Ins;
Oshkosh WI 54903-1128. Cora~e~cmg work without permit(s) will resu!! in fee
normal permit fee, wl~ich ever is greater.
OR
/
lf....x,~t_, a re .a..._c on Ira c to ~
YOU want this proces
nnnlt SS
OWneR
CONTRACTOR
CllECK [] ALL APPL:
CATEGORY
,Ill,ingle Family !'"1'
t~articipatdng in the Permi.._fee Account System and
sed through your account
r,'l ln' O-e,r rd
CABLE
)uplex nMulti-Family 13Rental
FUEL ~l~as CIElectnc EISolid
ROil CISolar
' {~orced Air f'3Radiant
PAGE 01
Q/ OYH
OM T~qF ~ATFi~
=ction Services. PO Box 1128.
; being doubled or $100.00 plus the
CHIMNEY BEING l
All chimneys shall be
SYSTEM
DA:~E
DCornm ~rcial
C}New
l-lather
Ci~MNEY TYPE ](~'himney A EC.~!mney B
SfKAT LOSS ~As Approved IId~nlsting
ffru RATE Il]As Per Plan OVariable
DESCRIPTION OF Ala~. WORK BEING DONE
I
]Steam FIA/C [~Vent 121Electnc V1Hot Water f=lSuppl.nC¢
INED DSo ~es - LINER SIZE & MANUF
sized per t~e BTU's being vented.
E]Dircct Vent
EINot Applicable
[:]Other Value
VALUE (InclUding labor! and all materials including light fixtures) $
OR ~ Eh~cirlc Installation Veri
E/cctrlcnl ~nxtnllation of nt, w/reph~cem
ELECTRICAL CANT!
ave adequate lands, check here
.~CTOR .~n~tt~.a r'~
r=llndustrial
~Replace
a. Burner
~CTURER
:her
~cation form attached(If Rtplaecmc.~)
'~t eqmpmenl shall ~ done b)' licensed contractor,
12/09/2002
23:56
Ci~
Divisi
21~C
PO I~
192042G1890
STEINBRUNER HEATING:
n. of Inspection
It)O
~, WI $4'~2-1130
Electric Installation Verification
L(Electrical Contractor Name)
(Acldress) I (City)
have been con~actca t~ pcrfo~ ~lcctdc installation work for ~/~
I
~ thc following add,ds: ....... ~ 5~.._.~. g ~r tO
(Address where work will be pcrfoa
.v~._~ nz.~rc of thc work
.XfRec
Rec
Rec
(State~ (Zip Code)
consists of: (Check Oue or Describe thc Nature of','t
0
contracted to)
annection or new circuit for replacement Heating Plant
annection or new circuit for replacement Electric Wale
annection of the Service Entrance Cable, Meter Box, a
lighting fixtures due to aiding / soffit installation. Notei: New Service Entrance
Eables will require a separate pcm~it.
Rec!onnection or new circuit for other pem~anently wired a~pliances / fixtures.
Other
iork $ / z
work will bc performed by an employee of this cornpa' ~y and further verify the
dlation will be done in compliance with manufacturer ~nd Electric code
(Pdnt Name of Office,')
PAGE 02
The value of this v
I hereby yeti fy thi.,
reconneclion / inst
requirements.
~-g~mturc o~ C°m~any Officer)
,ed)
ork)
and/or AJC Condenser.
, Heater.
terations to receptacles and
(Date)