HomeMy WebLinkAbout0098407-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1245 W 11TH AVE
GARTMAN MECHANICAL SERVICES
No
98407
~J Gas I ~ Oil
[] New I
[_J Forced Air
~j Electric
Chimney Type
Heat Loss
BTU Rate
Use/Nature IFR/
of Work
Chimney A
~(~ As Approved
O As Per Plan
[~ Radiant
L~ Hot Water
Owner WILLIAM A HANNEMAN
Category 500 - Residential-Heating & Ventilating
Chimney B
~ Existing
(~ Variable
~J Electric
[] Replace
Steam
Suppl.
Solar
L-J NC
U Con. Burner
Direct Vent i~ Not Applicable I
O Not Applicable I Value
O Other I Value
Create Date 1'1/04/2002
Plan
[~olid
[] Other J
Vent J
Install boiler. *EIV form from Beez Electric.
Fees: Valuation
Issued By:
$3,175.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$53.00
Date 11/04/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Address 520 W SO PARK AVE PO BOX 2264
Agent/Owner
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 w. ill not be processed.
O/HKO/H
ON THI~ 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 Permit fee Account System and have adequate funds, check here
if you want this processed through .your account-~
JOB ADDRESS
CH~K: ~ ALL~pPLICX~IL~
DATF. iOI~'~O ( 0~
FUEL
as F1Electric UlSolid SYSTEM F1New eplace
BOil F1Solar FIOther
TYPE
r'lForced Air VIRadiant F1Steam I-1A/C I"lVent V1Electrie
IS CItlMNEY BEING LINED l-lNo FIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
Hot Water FISuppl.
& MANUFACTURER
[21Con. Burner
CItIMNEY TYPE IZIChimney A El_Chimney B I-'lDirect Vent FIOther
HEAT LOSS [2]As Approved l-lExisting IZINot Applicable
BTU RATE nAs Per Plan VIVariable mOther Value ,?')
DESCRIPTION OF ALL WORK BEING DONE
VAL~'(In~/i~tii~g' labor and all materials including light fixtures) $
ELECTRICAL CONTRACTOR ~~¥~
[2] For applicable projects, an Electric Ins~ljafion Verification form., signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
18/31/2882
28:23
9202317255
BEEZ ELECTRIC
PAGE
02
City ~f O~k~i
l~OBo~ 11~0
~m~ 92~236.5~4
Electric Installation Verification
Beez Electric..Inc.
5.,21 W. 12th Ojhkosh WI 54902
have been contracted to perform electric installation work for .Crartman M~banical Services.
at the following address: I245 1 l~Av_e.
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting frxt~lres due to siding / soffit installation. Note: Hew Servic~ Entrance Cables
will requite a separate permit.
Reconnecticn or new circuit for other permanently wired appliances / fixtures.
Other ~.
Thcvalue ofthiswork!Ls $75.0._. 0
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements,
(Sigr~ture of Cornpany Offi~0