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OSHKOSH
ON THE WATER
Job Address 208210 W 20TH AVE
CITY OF OSHKOSH
No
123421
HVAC PERMIT -APPLICATION AND RECORD
Owner OSHKOSH HOUSING AUTHORITY
Create Date 02105/2007
Contractor GARTMAN MECHANICAL SERVICES
Fuel l!:I Gas UOil
System o New
l!:I Forced Air U Radiant
U Electric U Hot Water
Chimney Type K:) Chimney A . Chimney B
Heat Loss D As Approved . Existing
BTU Rate () As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
~ Replace
U Steam
USLJPPI.
C) Direct Vent
U Solar 0 Solid
o Other
U AlC 0 Vent
U. Con..Burner
C) Not Applicable
o Not Applicable
. Other
Value
Value
80,000
Use/Nature Duplex! Unit #210 - Replace furnace. EIV provided by Slim's Electric.
of Work
Fees: Valuation
$2,000.00
~
Plan Approval
$0.00
Permit Fee Paid
$40.00
Issued By:
Date 02105/2007
o Permit Voided I
Parcelld # 1406420000
In the performance of this work, I agree to perform all work pursuant to rules governing 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
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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.
:-:EB-05-2~07 05: 04 PM
-:- ,Uot. os 04 09:52a Oshko~h Inspections
::: . '
P.01/02
920-238-50B.<\
p. 1
City of Oshkosh
Division of IlISpcction Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HV AC PERMIT APPLICATION
All information. after bold categories must be pro\>'ided..
Incomplete applications wiU not be processed.
· Application(s) and foe(s) can be brought to City Hall, Room 205 Or mailed to lnspectionServices. PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doub,led or $100.00 plus the
nonnal permit fee, which ever is gl2ter.
OR
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JOB ADDRESS a \ C) . lc; Ci-L")C}\
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cONTRAcrOR . --.. . ~ Q
CHECK III ALL APPUCABLE
USE CATEGORY
OSingle Family ODuplex DMulti-Family
FUEL
~$
~ntaJ
o Commercial
o Induatrial
DElectric Dsofid
OSolar
SYSTEM
DNew
o Other
~CPlace
~E
,\~orcod Air. DRadiant .. [Js~am DAle OVcnt OElectric
IS CBlMNltY BEING LINED ~o DVes - LINER SIZE
Note: AU cbimne)'K.shall be sized pe/tk 8111's being vented .
DHot Water OSuppl. Dean.Burner
&MANUFA~
CBlMNEY TYPE DChinmey A. .~ imney a DDircot V cnt
HEAT LOSS OAs Approved Existing DNot Applicable
BTU RATE DAs Per' Plan ariable >>Other Value <60\ Cib
r--
DESCRIPTION OF AW-WOAABEING DONE~ ~ CO ~J.^f\ Or 1
OOthcr
~~=
\f:)~ \
VALUE . . '. . $ CDUJ O(~ . >>0r1'1Y)~~
~[. .. ... . \p
ELECTRlCAL CONTRACTOR ... . ~ ~e d "":7."'("_'. · .. . .
o For applicable projects, an' Electric Installation Verification fol1Tl, si~edby the Electrical Contractor, must be
attached. If not attaohed or not applicable, a separate Electrical Pennit.is requir~.
."
9/02
FEB-05~2007 05:05 PM
P. 02/02
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Electrie InstaUatjou Verification
SLIM'S ELECTRIC INC.
,
(BloctIicaJ Coatmctor Nune)
~608 Oakwood Circle Oshkosh WI 54904
(Addre85) (city) (State) (Zip Code)
ba"" bo.. COJIlt>clod ., )'OI'funn eloeiricinota1ladOll wod< Ibr ~\G ~ H.51 J III hf'
(Namo cfparty oontractod to) .
at tbe following addrou: d\D W OO~ _
(Address wbIR wort will ~ pmformed)
I (We).
The Daturc of the work c:onaim of. (Check One or Describe the NllturcofWork)
:t-
--
Recormeetion or new circuit for rcpl8CCllUCPt Heating }Jlant and/or A/C Condcnacr.
Rooonnection or new circuit for rcplacamtmt Electric Water Heater or power vented
W8ICl' bellter. .
R.ccoDDeCtion oftbe Service EDtntnce Cable. Meter Box, alterationJ to m:eptacles
and lishtina fixtures due to siding IlOmt installation. Note: New Semce
Bntnmce Cliblcs will ftlqub:e a separate permit.
Reconnection 01' new cirouit for tho rcpll1Cement of other pemwacntly wired
appliances J fixtures. .
New circuit for the ad4idon of Ale to ID'IJdMdtull dwtJI/tng unit (house or the
individual .)'!tems in a duplex or condominium). i=ludiq requiftld service
electrical outletS.
Other
Thevalueofthisworkis$ \~ ,C()
J hereby verify this work wiU be perfonned. by an employee of this company and further verify
thcroconnection / installation \VitI be done in compliaa.ce with manufacturer and BIee1ric code
rcquin=rnentls.
Q.
7)/?v I L) ~ ~ :J~J~/4 c7V; l OJ
. (Print Name of om (Date)
5"102
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