HomeMy WebLinkAbout0099205-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
247 W 6TH AVE
GARTMAN MECHANICAL SERVICES
Gas I
[] New
[~J Forced Air
~J Electric
II o,
L-J Radiant
[] Hot Water
Chimney Type ~..~ Chimney A (.~ Chimney B
Heat Loss ~ As Approved ~ Existing
BTU Rate ~ As Per Plan ~ Vadable
Owner SHARON A KRIZ
Category 500 - Residential-Heating & Ventilating
[~- Electric
[] Replace
~ Steam
[] Suppl.
L~ Solar
~1 Nc
Don. Burner
Direct Vent O Not Applicable I
O Not Applicable I Value
~ Other I Value
No 99205
Create Date 12/26/2002
Plan
I [] Solid I
[] Other I
Vent
Use/Nature SFR/Replace furnace. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,200.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided I
$38.00
Date 12/26/2002
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
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
OJI---IKOJ"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 ~r $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Perrni~.~fee Account S~_xte.m.. and hay.e, adequate funds, check here
i_f ¥Ott want this processed throttg~h_ your account I)FI
CIIECK ~
ALL APPLICABLE ............
'~ingie'F~iiY ~Duplex ~Multi-Family aRenial nCommercial a~dustfial
FUEL as ' fi]Electric I-ISolid SYSTEM fi]New bplace
IZIOil [] Solar F'lOther
,PE
creed Air I-IRadiant ElSteam fi]A/C fi]Vent IZIElectric
IS CHIMNEY BEING LINED FINe I-lYes - LINER SIZE
Note: All chinmeys shall be sized per the BTU's being vented.
[]Hot Water fi]Suppl.
. & MANUFACTURER
[Con. Burner
CIHMNEY TYPE fi]Chimney A fi]Chimney B fi]Direct Vent FIOther
HEAT LOSS fi]As Approved F1Existing fi]Not Applicable
BTU RATE []-lAs Per Plan I-IVariable I-IOther Value
DESCmPTION oF .aLL WORK BE NC. DONEr '
v.~I~UE (i~luding labor and all mate~:ials inciuding iight fixld)~s) $ <~-r~~' ~
ELECTRICAL CONTRACTOR ' ~~'1~.
13 For applicable projects, an Electric lnstallatia~ Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
i2/22/2002 2i:40 92023i7255 BEEZ ELECTRIC PAGE 0i
CiUy of 0.4,kmh
Diviaiou ~fli~p~oa S,~vio~s
iii Chuistm A',,uuwm
PO Box 11~0
Electric Installation Verification
Be..ez Electt~.'¢. Inc ......
52.1 W. 12lb_ Oshkosh
wi 54902
have been contracted to perform electric installation work for Gar?man Mechani.cal~
at the following address: 247 6.th StreW..
The nature of the work consists of' (Cheek One or Describe the Nature of Work)
[]
Recormee~ion or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnectiou of the Service ]Sntrance 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 / fixtu~s.
O~her
The value of this work is $15,0.00
I hereby verify this work will be performed by an employee of this company and fin-ther verify the
recoianection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Signature of Company Otlcer)
I2/23/02