HomeMy WebLinkAbout0103971-HVAC (boiler)OSHKOSH
ON THE WATER
.lob Address 424 N EAGLE ST
Contractor
Fuel ~ Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GARTMAN MECHANICAL SERVICES
Oil
Owner ADAM M/KARl L MESZAROS
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 ~ 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
103971
09/05/2003
Other
Vent J
Use/Nature SFR/Replace boiler. *EIV form from GMS.
of Work
Fees: Valuation
Issued By:
$1,950.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$35.00
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.
Cil¥ o f Oshkosh
Divisioa of Insb¢cfioo Services
P,O. Bax 1130
Oshkosh, WI 54g03-1130
Phone (920) 236-505~
Fax (020) 236-5084
HVAC PERMIT APPLICATION;
All lafor~ttoO after bold categories must be'prOvided.
l~lc;o applications ~ill ~o~ be p~ocesscd
Application(s) and fcc(s) can bc brought
Osl~kosh WI 54903-1128. Commencing
normal permit fcc, which ever is grealcr.
OR
\IJ~L ~.ATEGORY
%~gle Family
TYPE
~Forced Air ~Radianl ~Stgam ~C ~Vcnt ~El~o~c
IS CIi~NEY BRING LINED ~No ~Yes - L~R 81Z~
~o~o: All chi~oys shall bo sized per fl~ BTU'~
EIDuplox EIMulti-Fami!y IZIRcntal EIComm.m'O!~l~
E~Oth0r
CIIIMNEY TYPE vIChimney A. vlChimney B nD|rcct Vent . !E!Ofller
IIEAT LOSS I-lAs Approved nBxlaling Elliot Applicable
~TU RATE I-lAs Per Plan DVaria~ nOthcr Value .
,, .,PT,ONO ALL wo. KBE'.G.o. i.
ELEC~R/ICAL CONTRACTOR ~
For applicable projects, aa E!,,eh'io !~s{~llat!o~ V~rlfioatio~
' a[iached If not atlacbed or not applioobleo a separale Electrical Pa
9/02
Electric Installation Verification
(Electrical Contractor Name)
(Address) '
(City) (State)
have been contracted to perform electric installation work
at thefollowingaddress: ~ ~ss~wh
(Ad ere work will be performed)
The natm'e of the work consists of'. (Chock One or Describe the Nature of W0rk)
Recormocfion or new circuit for replacement Heating Plans
Roconneefion or n~w circuit for replaeemcnl Electric Water
water heater, i
Recormocfion or'he Service Entrance Cable, Meter Box, altora~0ns 1[o r
and lighting ~tures due to siding / soffit installation. Note: Nev
EnWan.ee Cabj.es Will require a separate permit.
RoconnocUon or new Circuit for the replacement 'of o~er pemaanent!y wired
appliances / fixtures.
New circuit for the aadition of WC to an individuat ~.dfl:g. Unit (h0~
individual sS'~-t~ras j~n s. duplex or condominium,), mclt3ding required
electrical outlets.
Other
The value of this work is $ I~")v~J,~
I hereby verify this work will be performed by an employee o£this company and ~. ~
the roconnoction / installation k, ill be done in compliance with manufacturei' and Eloctri,e
requirements.
(Print Name of Officer)
(D~e)