HomeMy WebLinkAbout0099296-HVAC (boiler)OSHKOSH
ON THE WATER
,Job Address 442 W 5TH AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GARTMAN MECHANICAL SERVICES
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MARY J BEARDSLEY
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99296
01/03/2003
Other
Vent J
Use/Nature SFR/Replace boiler. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,980.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$50.00
Date 01/03/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 520 W SO PARKAVE PO BOX 2264 OSHKOSH WI 54903 -2264 Telephone Number
(920) 231-5530
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
OJl-tKO/H
ON THE WATER
· Application(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permi, t fee Account System and have adequate funds, check here
if you want this processed through your account '~
RECEIVED
"' '' 'DEC
CHECK [] ALL APPLICABLE
~Single Fmily ~Duplex DMulti-Fmily ~Rental
FUEL
Gas
Oil
ElElectric F1Solid SYSTEM FINew eplace
EISolar ElOther ~
TYPE
EIForced Air ElRadiant FISteam FIA/C ElVent F1Electric
IS CHIMNEY BEING LINED F1No I--lYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
I-iCon. Burner
CHIMNEY TYPE U1Chimney A FIChimney B FIDirect Vent FIOther
HEAT LOSS r'lAs Approved FIExisting ElNot Applicable
BTU RATE F1As Per Plan FIVariable EIOther Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (InclUdi6~ labor and all materials including light fixtures) $ ~ ~0~ ~)(~
ELECTRICAL C ONTRAcTOR~ ;k~'--/7--~
[] For applicable projects, an Electric Ing.~ilation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02