HomeMy WebLinkAbout0100171-HVAC (heaters)OSHKOSH
ON THE WATER
.lob Address 36 E 10TH AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
STEINBRUNER HEATING & COOLING
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner EVERETT IND BLDG CO
Category 510 - Ind. & Comm-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA O Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100171
03/12/2003
Other
Vent J
125m
Use/Nature
of Work
Replace 3 old radiant unit 5 heaters with tube 50 type. *EIV form from Seckar Electric.
Fees: Valuation
Issued By:
$3,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$50.00
Date 03/12/2003
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you want this processed through pour account r~
i ·
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY 1--~o/1 IotO
I-1Single Family FlDuplex
nMulti-Family F1Rental mCommercial l~llndustrial
FUEL I~Gas [3Electric [3Solid SYSTEM [3New I~Replace
[3Oil F1Solar [3Other
TYPE
F1Forced Air I~Radiant [3Steam [3A/C [3Vent [3Electric [3Hot Water [3Suppl.l-lCon. Burner
IS CHIMNEY BEING LINED I~qo I-lYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's be!ng vented.
& MANUFACTURER
CHIMNEY TYPE [3Chimney A l~]Chimney B nDirect Vent [3Other
HEAT LOSS [3As Approved l~Existing nNot Applicable
BTU RATE l-lAs Per Plan [3Variable F'lOther Value i ~ oo o
DESCRIPTION OF ALL W_O.P~K BEING DONE. ,.e'¢~l~ Flqe O
VALUE (Including labor and all materials including light fixtures) $ ~¢ O OO ~__o
ELECTRICAL CONTRACTOR ~O.~ff-.xg r~ OR ~g~ Electric Installation Verification form attached(If Replacement)
Electrical installation of new~replacement equipment shall be done by licensed contractors.
3/02
O./'HKO. fH
ON THE WATEiq
City. of Oshkosh
Div/sion of Inspection See'ices
215 Church Avenue
PO Box 1130
Oshkosh WI 54902-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(0 (We)
(Address)
(Electrical Contractor Name)
(City)
have been contracted to perform electric installation work for
at the following address:
(State) (Zip Code)
(Name of party contracted to)
(Address where work will be performed)
work of' "'-'~ "
,.,,~l~t~ ~.,..nec~ One or Describe 'the Nature Of WORK)
,~" Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / iixtures.
Other
The value oft?tis work is $ ! &%°°-E-
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Print Name of Officer)
(Date)