HomeMy WebLinkAbout0100688 H(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 251 N LARK ST Owner WILLIAM J BOUSHELE
Contractor STEINBRUNER HEATING & COOLING Category 500 - Residential-Heating & Ventilating
Fuel ~ Gas J ~ Oil b~ Electric ~ Solar
System ~ New ~ ~J Replace ~ ~J Other
~ Forced Air I ~ Radiant L~ Steam ~ A/C
~ Electric I ~ Hot Water b~ suppl. ~ Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 60M BTU
No
Create Date
Plan
~J Solid
Vent
100688
04/08/2003
Use/Nature SFR/REPLACE FURNACE AND LINE CHIMNEY. *EIV FORM FROM SECKAR ELECTRIC.
of Work
Fees: Valuation
Issued By:
$2,200.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$38.00
Date 04/08/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 -0
Telephone Number
(920) 426-1830
.,04/07/2003 20:43 19204261890 STEINBRUNER HEATING: PAGE 01
City of Oshkosh
glavi$ion of Inapectiou Services
P,O- Box t 130
Oddtosh, W! 54903-1130
l~one (920) 236.5050
lax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided
Incomplete applicatiom will not bc processed,
, Application(s) and fe~(s) can be brought to City Hall, Room 205 or mailed to Insl
Oshkosh Wl 54903-1128. Commencing work without permit(s) will result in let
normal permit fee, which ever is greater.
OR
1£ you arq a toni_factor l~orticipar_~n_.g in the Permit [~e A¢..~.j)_unt S~.$tem and.
~__)'ou want this proce~ed throueh votJr acco.q~ ~
DA
JOB ADDRESS ,,.~_~//L/,
CONTRACTOR ~_.~c~ bra
nMu!ti-Family UIRental I-IComn
CllECK {~I ALL APPLICABLE
IJSg CATEGORY
,l~ingle Family ClDuplex
FUEL {~a$ nElecthc r'lSolid SYSTEM [-INcw
FIOil FISolar F1Othe
~orced Air
r'lRndianl FISteam EIA/C FlVent FIElectric F1Hot Waler nSuppl.~C
IS CHIMNEY BEING LINED U1No I~s - LINER SIZE _
Note: All chimneys shall be sized per the BTU's being v.med.
ection Services, PO Box 1128.
s being doubled or $100.00 plus the
~ave adeauate [u. ndz, chegk here
ercial
,n. Burner
ClllMNEY TYPE VIChimney A VIChimney B
II, AT LOSS ~As Approved Iil]'~isting
BTU RATE nAs Per Plan VIVariablc
q,~ ~ ...... & MANU
~irect Vent
13Not Applicable
VIOther Value
DESCRIPTION OF ALL WORK BEING DONE~a
rACTURER
)ther
ELECTRICAL CONTRACTOR~. ~-. ~--r-)~a r~
VALUE (Including labor and all materials including light fixtures) ~
O~ ~ Electric Installation Vt
Eh,c.~cn/ to,foliation of new/replnc~
nlndustrial
tffi~'eplac¢
1/02
rification form attached(If Re~laeemenO
meat equipment shall be done lO' licen~ett conrrnrtors
.~04/07/2003 20:43 19204261890 STEINBRUNER HEATING: PAGE 02
(we)
Electric Installation Verification
(Elect~cal Contractor Name)
(Address) (City) (Stat(
have been contracted to perform electric installation work for
at the following address: _
(Zip Code)
(Name ofpa~ ty contracted to)
(Address where work will be perfor
The nature of thc work co:lsists of: (Check O~c or Describethe Nature of
Reconnection or new circuit for replacement Heating Plal
Reconnection or new circuit for replacement Electric War(
Reconnection of the Service Entrance Cable, Meter Box,
lighting fixtures due to siding / soffit installation. Not~
Cables will require a separate pem~it.
Reconnection or new circuit for other permanently wired
O~er
The value of this work is $_._Z.~,.~~,
[ hereby verify this work will be perforated by an employee of this cornpa
reconnection / installation will be done in compliance with manufacturer
requirements.
(Prin! Name of Officer)
meal)
v'ork)
! an,i/or A/C Condenser.
x Heater.
Iterations ~o reccptacles a~ad
New Service Entrance
)iiances / fixtures,
ay and further verify thc
md Electric code
(Date)