HomeMy WebLinkAbout0085049-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address 711 KIRKWC)(ln nR
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
Owner WILLARD E SMITH
No 85049
Create Date 01/18/2001
Contractor STEINBRUNER HEATING & COOLING Category 500 -Residential-Heating & Ventilating Plan
Fuel / Gas Oil Electric Solar Solid
System ~ New ~ ~ Replace ~ ~ Other
Forced Air Radiant Steam A/C Vent
Electric / Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value GU-4 BOILER
Use/Nature
of Work
electric permit required-received installation verification signed by Seckar Electric)
Fees: Valuation
Issued By:
Permit Fee Paid $42.50
Date 04/03/2001
Plan Approval $0.00
Permit Voided
In the perfonnance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 - 0 Telephone Number (920) 426-1830
01/17/2001 10:27 14144261890 STEINBRIJNER HEATING: PAGE 01
Biviai n of xnepeccia~ Services
Z~5 ch~rch AvenuE
P.O. B x 1130
~~~ oshko HI 5aF03 1130
Fax M (F2o} 236 `.08~
Phone I(920) 236--5048.
I
~ HVAC PERMIT APPLICATION
All fields/information after bold categories mist be- provided.
Incomplete applications will not be processed-
~ D~~ 1- I ? - O F
JOB ADDRESS (~ r~ ~tr'I~uJt?at~
ONNER W t 4 Gtr"t~_i
COI~TRJICTOR ~ Y-jQhth,tl'`
CIRCLE ALL Rr
Q$E C!-TSGORY
6Y9?E!d
TYPE
I8 CK2IQ+TEY BEIMq
Note: All chimney
CHZ2Qd8Y TYPE
RE11T LOSS ',
BTO RATS
l~1TtTR8 OF NOR1C
DUPLEX MUI:TT- FAIIILS' COMMERCIAL T~1C)USTRIAL-
OIL. _ EI-FCTRIC SOS.. SObLII
NEW REPT,AG OTHER
AIR RA1)IAAIT STEAM A/C VENT
tIC NOT WATER SUPPL. CON. BURNER
LiNBD (i't~sr3fihSI,INER SIZE MANUFACTURER
shall be sized per the BTU's being. vented.
C13IMNEY A HIMNEY QIRECT VENT OTHER
AS APPROVEp ~ IS~fT~~ NOT APPLICAHL,E:
AS PER PLAN VAR2ABLE OTHER VAi,UE~U-~-{ IJe~IFr
VALIIB (Zncludin~ labor and materiale~ S 7-3~Jo;8~
ELECTRICAL CONT CTOR ~G~-ci ~
Electrical instal
at ion ___
_
of newjreplacement equipment.
shall be
done by liren~ed
contractor~-
Valuation Fees.
$0 to $1,Q00.00 . .................. .............................................................................. ..................•----- --------.....SZ0.00
$1,000.01 to S1 .000.00.......... .....................~......,...W.__......__.__~__ ~..__.__~_.__ ._._.._.__.$20.00 for first
Sl, 000.00 pTua SI:§{l pe-r 51(3D•:OO valuat~.on or part thereof
510,000.01 to $ S, 000. 09 ....................•
....
......... ..... 5155:00 for first
......-------
$:0,000.00 plus S1.00 per $100-00 valuation or part thereof
Over $25, 000. 00 . .................. .............................................................................. ........................ .............S305 . 00 plus 50 . SO
per S100.fJ0 valuation or part thereof
• suLuiil, payu~ei t wiLG ~-pplication- Failure to pay with in 3i~ days wi21 xesuit in
fees being d ubled ox- 5100-00 plus the nurmal• p-ernrit f-ee, wh3Ch ever is
greater. ~
FROM SECK.AR ELECTRIC
~~lu
Ott iw~E W.~TIP
City olOslJcoh6
Dinsion o! Ins~foetwn Ge.vip~s
Zli CAutet. Avawe
Pt? Box ! 130
OshkexA w1549o2.1t30
Ot'rue 42Cr23b-058
F.u 920-436 SOSe
FAX Nn. 92@23!395@ Ian. !7 20@! @6:41PM P!
~~
Electric ~nstgllation verification
Soctcar Electric Company tncr
(Electrical Contractor Name).
5920 Courtney Plummer Rosd~ Winneconne. Wisconsin 549$6
(Address)
(City)
(Mace) (Zip Code)
have been contracted to perform electrr'c-installation work'fo~~6 ~~ ~ ~
(Name cr( party.contracted to)
at the following address: 711 KIRKWOOD DR1V[r
(Address'where ~wt3rk ~l~ Ise per€ornncd) .
?he nature of ti~work consists o€: (heck Qee Qr.}t?eser~e:~Iattu~~f.Worlej ,
ti
Reconnectio~a or new circuit fm replaeem;e>!l~t•Keatirtg Floret and/or A/C Condenser.
~ Reconnection or new circuit for replacement Electric Water Heater,
Reconnection ot~tlte~Service Entrance Cable;' IGfirter Bolt; alterations to receptacles and
liglttiag fixtures due t4 siding,! soffit- installation Note:. stew Service Entrance
Cables will require a separate permit. '
Recorrneetion ox, r;~ru.o~et~i.€or atltex.~tl~.vtrir~.app}Iantces/fixtures.
Other -
The value of this work is $ ~ ~ ~~ C? ~~
I hereby verify this work will he performed by an employee of thin ootnpany and further verify the
reconnection /installation will-bedorte in compli-ante wliha>~nttfacc~er.a~l•Eketric code
requirements.
1
i, ~ ~ ~ ~ (`
c
(Sigtature o Company Officer)
Diane it- Seckar Janutary 1 ~, 200t
(Print I~latn$ sf ~~. (Date}