HomeMy WebLinkAbout0098522-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature
of Work
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1901 ALGOMA BLVD
GARTMAN MECHANICAL SERVICES
~ Gas I [] Oil
[] New J
[~ Forced Air J ~_J Radiant
~--~lectdc I ~' Hot Water
Chimney A ~ Chimney B
~.~ As Approved ~ Existing
~ As Per Plan ~ Variable
O~vner CITY OF OSHKOSH
Category 500 - Residential-Heating & Ventilating
~-ectric 1 [] Solar
[] Replace
~1 Steamj LI Nc I
[] Suppl. ] ~ Con. Burner l
Direct Vent ~ll Not Applicable J
0 Not Applicable J: Value
0 Other I Value
No
Create Date
Plan
[] Other
11/08/2002
LJ Vent
'RIVERSIDE CEMETARY/Replace hot water boiler. *EIV form from Beez Electric.
Fees: Valuation
Issued By:
$2,950.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided
$0.00
Date 11/08/2002
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 PARK AVE 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
RECEIVED
NOV 0 6 2002_
HVAC PERMIT APIBE Iffi i OF
All information after bold
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER:
· Application(s) and fee(s) can be brought to City 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
~£ you want this processed through your account ["] ~x.~o.~ (D-.~O_,_~L).Q.~
DATE It !5 I{--~
CHECK [] ALL APPLICABLE
USE CATEGORY ~..
ElSingle Family [3Duplex [3Multi-Family I-qRental'~Commercial Ellndustrial
FUEL F1Gas F1Electric F1Solid SYSTEM ElNew X'~eplace
UlOil F1Solar [2Other
TYPE
FIForced Air FIRadiant F1Steam FIA/C [2Vent F1Electric 'N~tot Water F1Suppl.
IS CHIMNEY BEING LINED F1No I-lYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
F1Con. Burner
CHIMNEY TYPE [2Chimney A F1Chimney B [2Direct Vent F1Other
HEAT LOSS I-lAs Approved [2Existing [2Not Applicable
BTU RATE F1As Per Plan I-1Variable F1Other Value
DESCRIPTION OF ALL WORK BEING DONE . _(' iI.~~l-'~,~_~[ }'"{~'[...~.~..L~.q.~'~f"~. 0,._.,j(_._~q
VALUE (Including labor and all materials including light fixtures) $
ELECTRICAL CONTRACTORC--~ LA~%O,~
[] For applicable projects, an Electric ~tallation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
~ ~1/05/2002 04:07 9202317255 BEEZ ELECTRIC PAGE 01
~I~ ~bu~h Z vmu~
POBog 1130
Oshkosh WI
Electric Installation Verification
(I) (We) B__e_ez Electric~Inc,
5._2! Vv'. 12th Oshkosh
54902
have been comracted tc perform electric installation work for Gartman Meehatfic~L
at the following address: 1901 Al oma Blvd..
The nature of the work ~nsists of:
(Che~k One or Describe the Nature of Work)
Keconnectioa or new drcuit for replacement Heating Plant and/or A/C Condenser.
Recormectio, a or new circuit for replacement Electric Water bleater.
Reconnect/on of the Serv/ce Entrance Cable, Meter Box, alterations to recept~les and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require ~: separate permit.
Reconnectio:,~ or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work i:; $150.00
I hereby verify this work will be performed by an employee of this company and further verity the
reconnection / installatic,n ~il be done in compliance with manufacturer and Electric code
requirements.
of Cor r,a" ; O cer)
Ga~_Bie. si_ng~ 11/05/_02