HomeMy WebLinkAbout0102643-HVAC (furnace)(~ CITY OF OSHKOSH No
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2455 HAMILTON ST Owner MR/MRS RONALD G LABORDE
Contractor STEINBRUNER HEATING & COOLING Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas ~ ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~ Forced Air I ~ Radiant L~ Steam ~ A/C
~J Electric I ~J Hot Water b~ suppl. ~J 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 0
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 40m btu furnace
102643
Create Date 07/03/2003
Plan
~J Solid
Vent
Use/Nature SFR/Replace furnace and chimney liner. *EIV form from Seckar Electric.
of Work
Fees: Valuation $2,000.00 Plan Approval $0.00 Permit Fee Paid $35.00
Issued By: Date 07/03/2003
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
07~02/2003 21:47 19204261890 STEIHBRUNER HEATING: PAGE 05
City of Oshkosh
D~vision of Inspection Servi
P.O Box 1130
Oshkosh. Wl 54903-1130
lq~ne (920) 236-5050
~nx (920) 236-5084
· Application(s) and Iq
Oshkosh Wl 54903-
normal permit fee, w
OR
I~Lpu a~ a con{facto
ff }-ou want this
SOB A~I)RESS
OVmZR_
CONTRACTOR
CIiECK [~ ALL APPI
~inCkTEGORY
glo Family C
FUEL ~as
I~O~l
~orced Air FIRadiant
HVAC PERMIT APPLICATION
All information after bold categories must be provided
Incomplete applicatiom will not be processed.
frs) can be brought to City Hall, Room 205 or mailed to Ins!
128. Commencing work without permit(s) will result in fee
rich ever is greater~
oarticiD(~in~ in the Permit fqe AcC_~unt System and
sed through vottr account ~
DA
ICABLE
Duplex ClMulti-Family FIRental UlComa
ClEIcctric ~Solid SYSTEM ~New
r'lSolar FIOtht
QSteam I~A/C r3Vent ~Elecmc DHot Water ElSuppl.~C
cc{ion Scl'vices, PO Box 1128,
s being doubled or $100.00 plus thc
ave adequate funds, check here
~ereial
IS CHIMNEY BEING
Note: All chi,.lneys shall I:
CmMNEY TYPE
HEAT LOSS
BTU RATE
DESCRIPTION OF A
LINED CINo ~'Yes - LINER SIZE
~ sized per ~e BTU'$ being vented.
FIChimney A FlChimney B
C'lAs Approved ~xi$fing
DA~ Per Plan ~Variable
LL WORK BEING DONE
'3 ' & MANU
~ircct Vent l-1,
~Not Applicable
[3Other Value ~
f
on. Burner
VALUE (Including labc
ELECTRICAL CON]
r and all mater,als including light fixtures) ~
~CTOR.~ OR ~J~El~ctrlc Installation Ve
[] Industrial
~cplace
· atica{ion form attached{if Rcplaccrr~m )
FACTURER
){her
· 0~/02/2003 21:47 19204261890 STEINBRUNER HEATING: PAGE
I (we)
(AC
have been co
at the followi
The nature
The value of
I hereby venf
the reconnect
rcquircmcnts.
(Signature c
Electric Installation Verificati,
2_to tlC_,.. ~'/--Ec-Tie:l c. (--:o~¢?,-s.tV
(Electrical Contractor Name)
.'o Coott'r~3'· ~-v/~?,e--t~ g.b.
tress) (City)
iracted to perform electric installation work for
,g dress: J v
(Address where work will be pe
Ihe work condors of: (Check One or Describe the Natu
:econnection or new circuit for replacement Heating PI~
:econnection or new circuit for replacement Electric W~
water heat~,
:econncction of thc Service Entrance Cable, Meter Box
and lighting fixtures due to siding / soffit installation
Entrance Cables will require a separate permit.
,¢connection or new circuit for thc replacement of othe~
appliances / fixtures.
few circuit for the addition of A/C to an individual dwe~
individual systems in a duplex or condominium), inc
electrical outlets·
~ther
,is wo,~ s s I Z ¢
this work will be performed by an employee ofthis c¢
m / installation will be done in compliance with manu
f Company Officer)
~>IA~, SEct-a/e:.
(Print Name of Officer)
(State) (Zip Code)
of pal~y contracted to)
fformed)
'e of Work)
m and/or MC Condenser.
~ter Heater or power vented
alterations to receptacles
Note: New Service
,ermanantly wired
ng unit (house or the
uding required service
npany and further verify
cturer and Electric code
7 -2 -03
(Date)