HomeMy WebLinkAbout2003-HVAC (a/c)OSHKOSH
ON THE WATER
Job Address 811 RANDALL PL
Contractor
Fuel [] Gas 7
System [] New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
STEINBRUNER HEATING & COOLING
Forced Air J
[] Electric
Radiant
Hot Water
Owner MARY L BLANCHETTE-HUNN
Category 501 - ResidenfiaPAir Conditioning
[] Electric
[] Replace
~J Steam
I. I sup¢·
No 102754
Chimney Type ~ ChimneyA ~,~ ChimneyB
Heat Loss ~..~ As Approved ~..~ Existing
BTU Rate ~ As Per Plan { ~ Variable
Use/Nature ISFR/Install 1.5ton NC. *EIV form from Seckar Electric.
of Work
Create Date 07/03/2003
Plan
[] Solar 7 ~ Solid
[~. Other
L~J NC j ~J vent
lOom Burner j
1.5 T NC
Direct Vent ~ Not Appliceble j
Not Applicable J Value
Other I Value
Fees: Valuation
Issued By:
$1,000.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided j
$20.00
Date 07/11/2003
In the pefformanceofthiswork, I agree to pefformallworkpumuantto rules governing the described construction.
Signature Date
AgenFOwner
Address 600 OREGON STREET OSHKOSH wi 54902 -0 Telephone Number (920)426-1830
. . .8i/02/2883 21:47 19284261898 STEINBRUNER HEATING: PAGE 03
City or Ost~osh
l~visiou of Impection Servi :es
!~.O, Box 1130
O~Igko~h, WI 54~3-1130
~ne {9201
fsx (920) 236-~084
· Applicalion(s) and
Oshkosh WI 54903-
normal permit fee,
OR
If ¥~u are a contracto
if you want this proce,
,lOB ADDRESS
OWNER
CONTRACTOR._~
CHECK [] ALL APPI
SiCATEGORY
ngle Family C
FUEL rlGas
C]Oil
'rvlq~
rlForced Air V1Radiant
IS CHIMNEY BEING
Nme: All chirnn~s shall I:
CHIMNEY TYPE
HEAT LOSS
Iftll RATE
DESCRIPTION OF A
VALUE (Including lab,
ELECTRICAL CON~'
HVAC PERMIT APPLICATION
All information afl~l' bold categories must be pmvide~
Incomplete applications will not be processed,
:(s) can be brought to City Hall, Room 205 or mailed to lnsl
128. Commencing work without permit(s) will result in
· ~ich ever is Eh'eater.
D,~
ICABLE
Duplex F1Multi-Family [3Rental UlComn
[]~lecmc ElSolid SYSTEM dw
CISolar r'lOthe
~ sized pet the BTU'; being vented
ClChimnc3, A FqChimncy B ClDircct Vent
VIAs Approved C]E~isting r'lNot Applicable
VIAs Per Plan r-IVariable VlOther Value
WORK BEING DONE
r and nil materials including light fixtures) S
RACTOR .~X:~.AEa ~ O~R ~ Electric InslallaOoa
:etlon Services, PO Box 1128,
being doubled or $100.00 plus the
ia~e adettuaCe funds, check berg
rE__ ?- Z-o.3
~crcial Ullndustrial
~ACTURER~
)ther
on. Burner
~//} 13Replace
~7/82/2003 21:47 192042G1890 STEINBRUNER HEATING: PAGE 04
(We)
(Ad
have been co'
at the followi
The nature o
-¢
The value o
I hereby vez
Ihe re¢onnecl
requirements
(SignatUre ~
Electric Installation Verificati,
(Electrical Contractor Name)
~ess) (City)
ltractud to ~ffo~ eluc~c insialladon work for ~
(Address wh~r~ work will
the work consists of: (Check One or Describe the Nan
~econnection or new cimuit for replacement Heating PI
[ecormection or new circuit for replacement Electric W
water heater,
~connection of the Service Entrance Cable, Meter Bo~
and lighting fixtures due to siding t soffit installatio
Entrance Cables will require a separate permit,
leconnection or new eireuj! for the replacement of otb,
appliances / fixtures.
New circuit for the addition of A/C to an individual abe
individual systems in a duplex or condominium), iu
eledtrical outlets.
in
(State) (Zip Code)
o ue- , ,
e of pariy ~ontracted to)
:rfotmed)
re o f Work)
mt and/or ,adc Condenser.
ater Heater or power vented
alterations to receptacles
Note: New Service
permanently wired
Iling unit (house or the
luring required servie~
Other
~his work is $
this work will be performed by an employee of this c
un / installation will be done in compliance with mann
mpany and further verify
~cturcr a~d Electric code
,f Company Officer)
(print Name o f Officer)
Q-2 -0~
(Date)