HomeMy WebLinkAbout0122885-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 1141 ALGOMA BLVD
CITY OF OSHKOSH
No
122885
HV AC PERMIT - APPLICATION AND RECORD
Owner GERALD J STADTMUELLER ETAL
Create Date 12/13/2006
Contractor GARTMAN MECHANICAL SERVICES
Fuel ~ Gas UOil
System D New
U Forced Air U Radiant
U Electric o Hot Water
Chimney Type [) Chimney A . Chimney B
Heat Loss KJ As Approved . Existing
BTU Rate K) As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
R'J Replace
~ Steam
U Suppl.
U Solar U Solid
D Other
U AlC U Vent
U Con. Burner
() Direct Vent () Not Applicable
C) Not Applicable Value
. Other Value
Use/Nature SFRI Replace steam boiler. EIV provided by Slim's Electric. **DEBIT ACCT**
of Work
Fees: Valuation
$8,050.00
(ji/YM:J
Plan Approval
$0.00
Permit Fee Paid
$131.50
Issued By:
Date 12/13/2006
D Permit Voided I
Parcelld # 0507130000
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address
PO BOX 2264
OSHKOSH
WI 54903 - 2264 Telephone Number (920) 231-5530
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
~C-13-2006 03:54 PM
i Oot os 04 09, 52.
f" City of Oshkosh
Divi$ion ofInspection Services
P,O. Sox 1130
Oshkosh, WI 54903-l130
Phone (nO) 236--5050
Pax (920)236~5084
p, 0 1 /02
Oshkosh Inspections
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HVAC PERMIT APPLICATION
All information after bold categories must be provided.
mcomplctc applications will not be pro<:essed.
. Application(s) and fee(s) can be brought III City Han, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will resul1 in fees bc:ing doubled or $100.00 plus the
normf'!.l permit fee, which ever is greater.
OR
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CHECK IiJ ALL APPLICABLE
~S17 CATEGORY
~ingle Family
FUEL ~~s
DDuplex DMulti-Family
DRental
o Commercial
Olndustrial
OElectric OSo1id
OSolu
SYSTEM
DNew
OOther
~eplace
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VALUE _ . ~ ;1b3--C)', DC) ,a-^ r
ELECTRICAL CONTRACTOR ~_; .ry-..I'I ~Q cJ.x--< C J \~
o For applicable projects, an EleclJic Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or notapplicBb1c. a separate Electrical pennit is required.
'I'YPE
CJForcedAir ORadiant (Steam DAle DVent o Elcottic DHot Water DSuppL DCon. Burner
IS CBJ1\11"(EY BElNG LINED ~No DYes - LINER SIZE
Note; All chimneys lihall be sized per the BTU's being vented.
C8IMNll;Y TYPE DChimney A ~hinmey B DDirect Ven!
IlEA T LOSS DAs Approved xisting DNot Applicable
BTU RATE CAs Per Plan ariable DOther Vnlue
DESCRIPTION OF ALL WORK BEING DONE ~ Q {J ~ ~~
& MANUFAcroRER
DOtber
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DEC-13-2006 03:54 PM
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Electric InstaUatlon Verifteation
J (We)
SLIM'S ELECTRIC INC.
(Blectrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(A~) (City) (State) (Zip Code)
Iul.e be... _led to potfonn electric iDIIalJation wed: fot: ~ .t..f..~j A Q ttcU\
(Name ofifarty contracted to)
at the following addreas~ \ \ L\\ C1 ~ \Y...~ ^ 0
(~~ _ will bopafomted)
The nature of the worlc:conaists of: (Check One or Describe the Nature of Work)
*-
Rcconnect1on or now circuit for replecom.ent HeatiDs Plant and/or AIC Candcn&cr.
Reconnection or new circuit for replacmnent Elecnic Water Heat<< or power vented
willer boater.
Rcconnection of the Service Entrance Cable,. Me&cr Box, alterations to receptacles
and lighting fixtures due to aiding IlOtlit installation. N()[e: New Service
&1t:rBDce Cables wilt require a separate pennit. .
Reoonnection or new circuit for the replllCemmlt of other permanently wired
appliances) fixtureS.
New circuit for the a4didon of Ale to an rndM~1 dwelltng UIIft (hous~ or I:be
individQll s)'Items in a duplex or condominium). inc:luding ftlqlIired service
electrical outlets,
OUn:r
----,.
. The value oftbis work is $ CJ"SOJ au
] heroby verify this work will be perfonned by In omployoc ofthiu company aDd further verify
the reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
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72/tf(Jf) /1 )0~..:.I,';4
(Print Name of om
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(Date)
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