HomeMy WebLinkAbout0098721-HVAC (boiler)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
57 BAY ST
GARTMAN MECHANICAL SERVICES
L~J Gas ~ t ~J Oil I
[] New I
Forced Air I ~ Radiant
Electric t ~ Hot Water
Chimney Type ~ Chimney A {~ Chimney B
Heat Loss ~ As Approved ~ Existing
BTU Rate ~ As Per Plan ~.~ Variable
Owner DANIEL H KRIZ
Category 500 - Residential-Heating & Ventilating
[] Electric 1 ~ar
[] Replace I
~ Steam J ~c
[] suppl. ] ~--~n. Burner
Direct Vent O Not Applicable t
~11 Not Applicable Value
~ Other I Value
No
Create Date
Plan
[] Other
98721
11/19/2002
[] Solid
Vent
Use/Nature SFPJ Replace hot water boiler. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$3,490.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit VoidedI
$57.50
Date 11/19/2002
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 ef 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.
Qff'HKOff'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 ~)r $100.00 plus the
normal permit fee, which ever is greater.
OR
[f .¥ott are a contractor participating in the Permit fee Account System and have adequat,e_funds, .check he,re
i_fyou want this processed through_ ye.ur .accoun-fft~G]
JOB ADDRESS
OWNER
CHF~CK [] ALL APPLICABLE
USE CATEGORY
.~--l~Single Family U1Duplex
fi]Multi-Family
FIRental F1Commer¢ial FIIndustrial
FUEL ~._~Gas FIElectric ElSolid SYSTEM I-INew
U1Oil ElSolar F-IOther
--l~Replace
TYPE
UIForced Air U1Radiant FISteam UIA/C UIVent EIElectric 'x~Itot Water FISuppI.
IS CIIIMNEY BEING LINED UINo I-lYes - LINER SIZE
Note: All chimneys shall be sized per the BTLI's being vented.
& MANUFACIIJRER
I-ICon. Bumer
CHIMNEY TYPE F1Chimney A F1Chimney B F1Direct Vent FIOther
HEAT LOSS FIAs Approved FIExisting FINot Applicable
BTU RATE l-lAs Per Plan F1Variable UIOther Value
VALUE (Including labor and all materials including light fixtures) $, '~%?0- (-~-~
ELECTRICAL CONTRACTOR(~)~2~/-,~-----
[] For applicable projects, an Electric Ins l~tion Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, ~ separate Electrical Permit is required.
9/02
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(I) (We) Beez Electric, Inc.
521 W. 12th Oshkosh WI
54902
have been contracted to perform electric installation work for Gartman Mechanical,
at the following address: 57 Bay Street.
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.
Keconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $150.00
I hereby verify this work will be performed by an employee of this company and further verify the
:econnection / installation will be done in compliance with manufacturer and Electric code
equirements.
(Sign~ature of C
ny Officer)
Gary Biesinger 11 / 18/02