HomeMy WebLinkAbout0097704-HVAC (boiler)0
OSHKOSH
ON THE WATER
Job Address 1600 ALGOMA BLVD
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner DONALD L GERTH
No 97704
Create Date 10/02/2002
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 0
BTU Rate
As Per Plan
Variable
Other
Value
Use /Nature FR/ Replace boiler. 'EIV form from Seckar Electric.
of Work
Fees: Valuation $2,500.00 Plan Approval $0.00 Permit Fee Paid $42.50
Issued By: Date 10/02/2002
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
10/01/2002 09,24 - 19204261890 STEINBRUNER HEATING: PAGE 03
i
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903.1130
Phone(920)236 -5050
FOX (920) 236 -5084
HVAC PERMIT APPLICATION
All information after bold categories must be provide
Incomplete applications will not be processed.
V
• Application(s) and fte(s) can be brought to City Hall. Room 205 or mailed to Ins cction Services, PO Box 1128.
Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in ;fe s being doubled or 5100.00 plus the
normal permit fee, which ever is greater.
OR
JOB ADDRESS L6 Q c� %�'
OWNER Ce,,+ ,
CONTRACTOR�ru nov— iu
CHECK ® ALL APPLICABLE
USE CATEGORY
m14'gle Family ❑Duplex []Multi- Family ❑Rental ❑Comm rcial 01ndustrial
FUEL was ' CElectrie ❑Sitlid SYSTEM C7Ncw Mace
❑Oil ❑Solar OOther
TYPE
❑I+orccd Air ORadiant DSteam ❑A/C OVent ❑Electric tot Water ❑Suppl.❑Co . Burner
IS CHIMNEY BEING LINED ONo OYes - LINER SIZE Jd & MANUFACTURE
Note- All chimneys shall be piled per the BTU's being vented.
CHIMNEY TYPE 9 himney A OChimney B ODirect Vent 001her
HEAT LOSS OAs Approved arx"Isting ONot Applicable
8TV RA'Z'E 0AS Per Plan OVariable ❑Other Value
DESCRIPTION OF ALL WORK BEING DONE Ke
VALUE (including labor and all materials including light fixtures) Sao i!—�
a
ELECTRICAL CONTRACTOR Sc ,-ar OR ,R[ Eleetric Instatlaflon Vert Stion form anathed(VRcplaccmem)
VC10riral inaallafion of wwlreplaren+ r rquipmeef shall be done by licensed rnmraaors.
3/02
10/01/2002 00:24 - 19204261890 STEINBRUNER HEATING: PAGE 04
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ar 1"t VAR" PAR 9742363014
0) (We)
Electric Installation Verification
(Electrical Contractor Name)
(Address) (City)
have been contracted to perform electric installation work for
at the following address:
OAJA! LP-
(Zip Code)
(Name of patty contracted to)
where work will be
Tl;e r2tt:rc o.`thc ��ork consists of : (Check 015e or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plan and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, E Iterations to receptacles and
lighting fixtures due to siding / soffit installation, Not . New Service Entrance
Cables will require a separate perntit.
Reconnection or new circuit for other permanently wired 2ppliances / fixtures.
Other
The value of this work is $ 0
I hereby ved fy thi.s work will be performed by an employee of this comp
reconnection / installation will be done in cotnpliaocc with manufacturer
requirements.
9 S&GAA
(Signature oltCompany Officer) (Print Name of Of ices)
and further verify the
Electric code
(pate;)