HomeMy WebLinkAbout0105040 HOSHKOSH
CiTY OF OSHKOSH
HVAC PERMIT-APPLICATION AND RECORD
ON THE WATER
1110 LOCUST ST
STEINBRUNER HEATING & COOLING
[~- Gas
[] New
~d Forced Air
Electric
b~ Oil
~J Radiant
~r-Hot Water
Owner ROBERT D/YVONNE BITTER
Category 500- Residential-Heating & Ventilating
~j Electric I I I Solar
[] Replace I
~J Steam j LJ A/C
[,,. J Suppl. I [~]~on. Burner
Job Address
Contractor
Fuel
System
ChimneyType ~ ChimneyA
Heat Loss ~.~ As Approved
BTU Rate ~.~ As Per Plan
Use/Nature ~SFR/Replace furnace and
of Work
Chimney B O Direct Vent ~ Not Applicable I
~J~ Existing (,2 Not Applicable I Value
(...~ Variable ~ Other I Value
line chimney. *EIV form from Seckar Electric.
No
05040
Create Date 10/30/2003
Plan
Solid I
[] Other J
L~ vent
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $35.00
Issued By: Date 10/30/2003
[] Permit Voided i
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.
10/29t2803 14:43
Ci~, of Oshkoah
Divisio~ of Insl~ction Serv~
P.O, Box 1130
Oahkosh, WI $4903-1130
Phone (9:~0) 236-5050
F~x (920) 236-S084
19204261890
STEINBRUNER HEATING:
HVAC PERMIT APPLICATION
All information after bold categories must be provided
Incomplete applications will not be processed.
· Application(s) and f~c(s) can be brought to City Hall, Rooro 205 or mailed to Ins
Oshkosh WI $4903-j {28. Commencing work wilhoul pe~it(s) will ~suh in fc
n~a] pe~it fee, w~ich ever is ~eater.
OR ~
[~ )'o~, atT ~ contraCtO~ ~arrici~o~ing i~ the Perm~l ~ee ~ccoun~ System ~nd
~ Vou want this vroce, sed through your account ~
[C~BL~
)uplex UMulti.Family ~Renlal ~Com~
FUEL ~as F1EIcctnc [3Solid SYSTEM UINew
c'lOil ClSolar ClOth,
~orced Air [3Radiant
"lStcam El,MC .rqVenl ElElecmc r'lHot Water r3Suppl,Cl(
IS CHIMNEY BEING.'LIN~D ClNo ~en - I.INER SIZE ~," & MANU
N. re: All ¢h,nneys shall b sized per ~he BTU s being veated.
/
CHIMNEY TYPE '~}Chimney A I~Chimney B ~Direct Vent
II~AT LOSS !nAs Approved ~xisting I~Nnt Applicable
~ RATE T']As Per Plan ElVariable anther Value
DESCRIPTION OF ALL WORK BEING DONE_.~.~.L
VALUE (Including labor and all roaterials iaeludiag light
ELECTRICAL CON'~RACTOR~ OR
PAGE 01
ection Services. PO Box 1128,
bong doubled or $I00.00 plus lhe
ave ac]¢auate funds, checA /,ere
rE to~ z~ ~o~
~=rcial 1'31ndustna{
Burner
:ACTURER
Rher
10/29/2003 14:43 19204261@90
STEINBRUNER HEATING:
(I) (we)
Electric Installation Verification
(Electrical Contractor Name)
(Add.ss) ' (City) (Stat~
have been comracted'3o p~fo~ elect~c installation work for ~ ~
~c ofp~
(Address where wor~ will be petf~
PAGE 02
at thc following addr4:ss:
'k consists of: (Check Oue or Describe the Nature of
Th ..... u.c of thc wo
R,
:connection or new circuit for replacemcnt Heating Pla
:connection or new circuit for replacement Electric Wa
~ R, c.o. nncction of thc Service Entrance Cable, Meter Box,
. hghting fixtures duc to siding / soffit installation. No
[ Cables will require a separate pcm~it.
___ Reconnectton or new circuit for other pcm~ancntly wired
0 her
The value of this work is $ ] ~ ~
! hereby verify t]~$ work will be perform, ed by an enlployec of this com!c
reeonnection / installation will be done m compliance with maoufactnrc~
requiremants,
(Signature o{ Co npany Officer)
(Zip Code)
ty contracted to)
reed)
York)
t an,t/or A/C Condenser.
er Heater,
alterations to receptacles and
re: New Service Entrance
appliances / fixtures.
any and further verify thc
and Electric code
(Print Name of Oflice~
(Date)