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HomeMy WebLinkAbout0098408-HVAC (furnace)OSHKOSH ON THE WATER Job Address Contractor CITY OF OSHKOSH HVAC PERMIT -APPLICATION AND RECORD 929 EVANS ST GARTMAN MECHANICAL SERVICES Owner ARTHUR V JORDEE Category 500 - Residential-Heating & Ventilating Fuel ~ Gas I ~ Oil I ~ Electric I ~j Solar System [] New I [] Replace I L~ Forced Air I L~ Radiant j [~ Steam I [~ NC J ~j Electric t ~J Hot Water I U Suppl. I ~ Con. Burner I Chimney Type ~ Chimney A O Chimney B O Direct Vent ~1t Not Applicable I Heat Loss ~,~ As Approved ~ Existing O Not Applicable I Value BTU Rate ~) As Per Plan ~ Variable ~11 Other I Value No Create Date Plan [] Other 98408 11/04/2002 Solid b-J Vent Use/Nature SFR/Replace furnace. *EIV form from Beez Electric. of Work Fees: Valuation $1,975.00 Plan Approval $0.00 Permit Fee Paid Issued By: [] Permit VoidedI $35;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 Agent/Owner Address 520 W SO PARK AVE PO BOX 2264 OSHKOSH WI 64903 - 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 will not be processed. O/HKO/H ON THE 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 participatin~ in the Permit fee Account System and have adequate _funds, check here if you want this processed through your account'~.~ ' clVED NOV 0 4 CHECK [] ALL APPLICABLE x~Sihgle Family I-1Duplex V1Multi-Family I"lRental FUELI~lO~il ' [3Solaf[3EleCtric tfS0iid SYSTEM FINew [3Other [~Replace T E ~FPolrced Air I-IRadiant FISteam U1A/C r'lVent U1Electric \ IS CHIMNEY BEING LINED F1No l-lYes - LINER SIZE Note: All chimneys shall be sized per the BTU's being vented. F1Hot Water FISuppl. & MANUFACTURER ElCon. Burner CHIMNEY TYPE V1Chimney A [3Chimney B [3Direct Vent F1Other HEAT LOSS F1As Approved V1Existing [3Not Applicable BTU RATE FIAs Per Plan IDVariable DOther Value DESCRIPTION OF ALL WORKBEING DONE r ~rd'~ ~ ~_Z~)~j'~_G_,0._A~ V~E (Including labor and all materia!s including light fixtures) $ iq'~5. ~-) ~ ELECTRICAL CONTRACT0R ~~/~'x~ [] For applicable projects, an Electric Insta~ion-"Verification form, signed by the Electrical Contractor, must be attached. If not attached or not applioable, a separate Electrical Permit is required. 9/02 18/31/2882 20:23 9202~t17255 BEEZ ELECTRIC PAGE 01 C/~ of O~ko~h 1115 Cb~=~ POBox 1130 Os~osh WI .~-I!30 0~ P20.23E,5050 Fa~ ~/D-2,,.,.~-3~ )~t Electric Installation Verification (I) (We) Beez'Elec~¢~h_c~ 521W. 12th_ ~ WI ~4902 have been contracted to perform electric installation work for. _Gar!man Mechanical $¢rviees, at the followiI~ address: 929 Evans_Stae.~. Thc rmture or,he work consists of: (Check One or Describe the Nature of Work) Rcconnecfion or new circuit for replacement Heating Plant and/or AJC Condenser. Reconnectioa or new circuit for replacement Electric Water Heater, Reconnectioa ot'the Service Ilntrance Cable, Meter Box, alterations to receptacles and lighting fixates due to sidin~ / soffit installation. Note: New Service Entrance Cables will require it separate permit, Reconncetion or new circuit for other permanently wired appliances / fixtures. Other ~. The value of this work is $.7_5,00 I hereby verify this work will be performed by an er~ploye~ of this company and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. (Signature of Company Officer) ~alx_B. it, gttK~ 1._0I$ I/02