HomeMy WebLinkAbout0103970-HVAC (boiler)OSHKOSH
ON THE WATER
.lob Address 524 W NEVADA AVE
Contractor GARTMAN MECHANICAL SERVICES
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner KATHY L ROGGE
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
103970
09/05/2003
Other
Vent J
Use/Nature SFR/Replace boiler. *EIV form from GMS.
of Work
Fees: Valuation
Issued By:
$2,150.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$38.00
Date 09/05/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address PO BOX2264 OSHKOSH WI 54903 -2264 Telephone Number
(920) 231-5530
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
^pplication(s) and fee(s) eau be
Oshkosh WI 54903-1128. Commenoing Wor~ with0ul permit(s) will
normal permit fee, which w~,e:' is grea¢¢r.
OR
~ATI~
[~ingl¢ Family
mo
it
TYPE
~Forced Air ~Radianl ~S~ee'n ~0 ~Vont DEi~c lotWaicr
IS ClIiMNEY BEING LINED DNo ~Ye$ - L~ SIZE
Note: All chi~oyS shall bo sized p~r iho B~'s being Vented.
IZIDnplex I-IMulti-Family
I-llllcci~-ic' [ZlSolid.
[]Solar
C-~IlMNEY TYPE
ilEAT LOSS
BTU RATE
r'lChimney A
EIAs Approved
IZIAs Per P!an
ElChinmcy B
ElExisting
ElRentai ff-ICom~0roi~l '~ ~
DESCRII TION OF ALL WORK BEING
EIDireot Vent . EIOtimr
[lNot Applic~b!0
. IZIOIhor Vahio
VA LUE (l[nclmllt~}', labor ami all materials including Ilgh¢ fixtures} Sg '
E1.E~ICAL CONTRA~OR
~or applicable projects, an E!~gio !~s~llatlon Verifioalion fom~,
attuned. If not attaohe~ or not appliogbl~, ~ '
9/02
Of HKOJ'H
City of Oshkosh
Division of Impectlon Semnces
PO Box 1130
Oshkosh WI $a903-1130
Electric Installation Verffication
I(We) ; Gartman Mechanical
(Electrical Contractor Name)
520 W. Southpark Aven~e Oshkosh, WT 54902
(Address) (City) (State)
(Nam'eq)-~ pmy~h:act ed to)
at the following address: 5~U~ ~. ~ ~ ~ ,~,.~F'~.&~_
(Address where work will be performed)
(Zip Code)
The nature of the work consists off (Check One or Describe the Nature of Work)
~, Reconneefion or new circuit for replacement Healing Plant and/or A/C Condenser.
Reconnect/on or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installat/on. Note: New Service
Entrance Cables will require a separate permit.
Reconnect/on or hew circuit for the replacement of other permanently wired
appl/ances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominimm), including required service
electrical outlets.
Other
The value of this work is $ [O(h (~
I hereby yelify this work will be Performed by an emPloyee of this company and further verify
the rec6nnect/on / installation will be done in compliance with manufacturer and Electric code
rcqmrements. ~
(Signature of C~lalffany Officer)
(Print Name of Officer)
(Date)
5/02