HomeMy WebLinkAbout0083926-HVAC (boiler) 41.4...) CITY OF OSHKOSH N 83926
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1617 JACKSON ST Owner FRANCISCO /SANDY DE LA CRUZ Create Date 11/28/2000
Contractor STEINBRUNER HEATING & COOLING Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas 1 011 Electric 1 Solar 1 Solid
System New ✓ Replace Other
Forced Air I Radiant Steam __I NC i 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 ( ) Vanable O Other Value
Use /Nature SFK / REPLACE BOILER
of Work (No electric permit required - received installation verificaiton signed by Seckar Electric)
Fees: Valuation $2,500.00 Plan Approval $0.00 Permit Fee Paid $42.50
Issued By: Date 02/01/2001
H Permit Voided
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
11/28/2000 09:53 14144261890 STEINBRUNER HEATING: PAGE 01
Olvie' n of inopoctAon Servicce
215 C XCh Avenue
V.O. x 1130
Oahko , WI S6902 1130
T, Fax 4 1920) 236 5084
phone (92o) 236 So46
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
D RTE _ 11 2. -U v
JOB ADDRESS t ( ( 1 J4
OWNER e.tk .-A i /
CONTRACTOR gki rlb hL1l,/, r
CIRCLE ALL APPLICABLE
USE CATEGORY INGLE F;; ;I:› DUPLEX MULTI - FAMILY COMMERCIAL INDUSTRIAL
run iw OIL ELECTRIC SOLAR SOLID
SYSTEM NEW P = OTHER..
TYPE FORCED AIR RADIANT STEAM A/C VENT
ELECYRIC SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE 6,o
MANUFACTURER
Note: A11 chimneys shall be sized per the.BTU:s being-vented-
CHIMNEY TYPE CHIMNEY A CHIMNEY B DIRECT VENT OT
MEAT LOSS AS APPROVED �XIST NG NOT APPLICABLE /
BTU RATE AS PER PLAN VARIABLE OTHER VALUE � t _ `
MATURE OF NORK : 144C Lk a f/- 41
VALUE (Including labor and materials) $ a5 era
ELECTRICAL CONTRACTOR S4 c.
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation
Fee$
$0 to $1 000. 00 .................... .......... ..... $20.00
$1,000.01 to $10 000..00 $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $2.,000.00 $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 $305.00 plus 50.50
per $100:00 valuation vI part thereof
• Submit paymen with application. Failure t0 pay within -30 days, will result in
fees being do bled or $100.00 plus the normal permit .tee, which ever is
greater.
•
FROM : SECKAR ELECTRIC FRX NO. : 9202313950 Nov. 27 2000 07:59PM P1
City of Oshkosh
Division of Inspection Services
21 S Chinch Avenue
PO Box 1130 7,
f�� / Qshkoyh WI 54902.1170 I s,
W - 1V,.,1J H office 920 - 216 -5050
ON ME wn7EP Fax 920. 236.50n4 - -
J
Electric Installation Verification
(J) (We) Seckar Electric Company-inc. •
•
(Electrical Contractor-Name) .
5920 Courtney Plummer Road, Winneconne, Wisconsin 54986
(Address) (City) (State) (Zip Code)
Steinbruner Heating and Cooling
have been contracted to perform electric installation work for ,
(Name of party contracted to)
at the following address: 1617 JACKSON STREET
(Address where work will be performed)
The nature of the work consists •of; (Check 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 / fixtures.
Other
The value of this work is $ J 25. 00 .
I hereby verify this work will be performed by an- employee of- this - company and fitrther verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
•
d'i ?/ S Dian R. Seckar November 28. 2000
----.-___...---
(Signature o ompany Officer) (Print- Name of Officer) (Date)