HomeMy WebLinkAbout0104170-HVAC (replace boiler)OSHKOSH
ON THE WATER
.lob Address 316 W 16TH AVE
Contractor
Fuel ~ Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
STEINBRUNER HEATING & COOLING
Oil
Owner SUE F BRITTON
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO 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
No
Create Date
Plan
L~ Solid
104170
09/15/2003
Other J
Vent J
Use/Nature DULEX/Replace boiler. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,000.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$35.00
Date 09/15/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 -0 Telephone Number
(920) 426-1830
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
~9/15/2003 11:29 192042Gi890 STEINBRUN~R HEATING: PAGE 03
~ of Oshkosh
Division Of Inspection Scr~ces
P.O. Box 1130
Osl~osh, WI 54903-113{)
Iqmne (920) 236-5050
Itm {920) 236-$084
HVAC PERMIT APPLICATION
All information after bold categories must be provide
Incomplete applications will not be pxocessed.
!
Application(s) and I'Ve(s) can be brought In City Hall. Room 205 or mailed In Ins
Oshkosh WI 54903-I 128. Commencing work without permit(s) Vail rcsul! in tee
normal permit tee, w~ieh ever ts greater.
OR
if'YOu wa~t thiz t~roce~ed tltrou£h your ,ccount
ADDRESS
C?IlECK El ALL APPLI
CATEGORY
fqSingle Family
CABLE
~uplex r=lMulli-Family r'lRental
DA'
C{Commd
~as r'lElectric C]Solid SYSTEM C]New
[=]Oil [ I-ISolar ~Other
I~orced Air FIRadiant I~lSteam CIA/C [~Vent ClElecltic ~Hot Water nSuppl.nC~
~ ~Y BF..ING I[INED ~o I~Yes - L.qq£R SIZE & MANUF
:cdon Services, PO Box 1128,
s being doubled or $100.00 plus the
ave odequ~/te funds, check here
rcial C{Industrial
~l~eplacc
i. Burner
~CTURER
Noter All chimneys shall be
L~ItlMNEY TYPE
]~:AT LOSS
RATE
I~3CRIFIqON OF Al
'VALUE (Including labor
II~ECTRICAL CONTI
fized per the BTU's being vented,
IChimney A I-I~C, himney B [~/Direct Veal [2lc
IAs Approved ~ElExisting f-INol Applicable
las Pc~ Plan I'lVariable ~Other Value
WO. BE, G O
tad all materials including light fixtures) $ ~ ~
~CTOR .~:~tt r"' 0_~ ~ EIKfrJe Installation Verl~
~ilion form llttathtd(If Rcplaceme~t~
STEINBRUNER HEATING:
PAGE
Electric l $talhtion
l(We)
(Ad,
have been col
(Electrical Contractor Name)
tess) (City)
:racted to perform electric installation work for
/
at the followilg address: __ ~ ! ~, LO
(Address where work will be
The nature oflh¢ work consists of; (Check One or Describe the Nalu~
~_l~econnection or new circuit for replacement Heating Pit
l~econnection or llew circuit for replacement Elcclrlc Wt
The value ofl
wa~er heater.
¢conn~ction of the Service Entrance Cable, Meter Box.
and lighling fixtures due Io siding / soffit installalion
Entrance Cables will require a separate permit.
econn¢c~ion or new circuit for the replacement ofothel
appliances / fixtme, s.
few circuit for the addition of A/C to an individuM dwe.
individual systems in a duplex or condominium), inc
electrical outlets.
)ther
his work is $
I hereby vent'
thc reconnecti
requirements,
(Signa~r¢ ctf Company Officer)
this work will be performed by an employee of this cc
on / installation will be done in compliance with manuf
(Print Name of Officer
n
(Slate) (Zip Code)
: of party contracted to)
formS)
e of Work)
nt and/or A/C Condenser.
ter Heater or power vented
alterations to receptacles
Note: New Service
ermanently wired
ng ani~ (house or the
:uding required service
mpany and f~nher verify
~cturer and Electric code
(Date)