HomeMy WebLinkAbout0131559-HVAC (furnace & a/c)/~'~ CITY OF OSHKOSH No 131559
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATE R
Job Address 441 W 18TH AVE Owner DOROTHY STEINFORT REV TRUST Create Date 07/16/2008
Contractor GARTMAN MECHANICAL SERVICES Category 502 -Residential-Both Plan
Fuel / Gas Oil Electric Solar Solid
System ^ New ~ ^/ Replace ~ ^ Other
/ Forced Air Radiant Steam / A/C Vent
Electric Hot Water Suppl. Con. Bumer
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value
BTU Rate As Per Plan Variable Other Value
Use/Nature FR /Replace furnace and a/c. EIV signed by Slim's Electric. "debit acct
of Work
Fees: Valuation $4,840.00 Plan Approval $0.00 Permit Fee Paid $83.50
Issued By: ~j/j/yt,Q Date 07/16/2008
^ Permit Voided
Parcel Id # 1405590000
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
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.
L-15-2008 12;19 PM
City of Oshkosh
Division of Inspection Services
P.O. Box 1 ] 30
Oshkosh, W1 54943-1130
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.
P, 01/05
~ ~
~H ~ H
ON rHF WATFR
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-11.28. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater,
OR
** Advisory -For ayplicable projects, an Electrical In~Stallation Verification (BIV) form, signed by tkte Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE--~~-
.roB ADDRESS y~l/ W. L ~~ -
CONTRACTOR GYV1S i Ih~
CHECK ~ ALL APPLICABLE
ngle Family ^Duplex ^Multi-Family ^Rental CaCommercial ^lndustrial
FUEL Lt3L~as ^Electric ^Solid SYSTEM ^New La"~place
^Oil ^Solar ^Uther
orced Air ^Radiant ^Steam l!~'A/C ^Vent ^Electric ^Hot Water ^Suppl. I~Con, $urner
15 CHIMNEY BEING LINED 6~i~o ^Yes -LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized pcr the BTU's being vented.
CHIMNEY TYPE ^Chimney A li~iimney B ^Direct Vent ^Other
HEAT LOSS ^As Approved ta7~'xistin.g ^Not Applicable
BTU RATE ^As Per Plan ^Variable ~'C/tner Value fr+G~ ~ r~pni
DESCRIPTION /SCOPE OF ALL WORK BEING DONE IZn.n ~A rh.~ ~- ~r~ tt 4 ~c ~ ~ ~~-
cv
VALUE (Including labor and materials) $ _~ N~
ELECTRICAL CONTRACTOR (for projects not requiring an EN Form) ~ I w. ~ ~-~ t.~. l Cr
USFr CATEGORY
07/07
JUL-15-2008 12 20 PM
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Electric Iln~tallntton Vexiticatioa
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SLIM'S ELECTRIC INC.
(filectxical Comrector Noma')
P. 02/05
260$ Oakwood Circle Oshkosh WI 54904
(Alidreaa) (City) (State) (Zip Coda:)
~t.t~~ ~~
have beep eantracted to perf'onn electric inatallabiaaa work for u-'1 ~"'-~
` (None of party contracted to~~
at the following addreos: ~~~ ~,~ l ~`~
(Address wba~ work wiU be perPottrled)
The nature of the work coneiats of: (Check One or Aaacrs~e the Net>~e of Work)
Recormecaoa or nCw circuit for replacantertt Hosting Pltaat and/or A/C Condmscr.
Reconnection or new asirclut for replaoe~toat Electric Water Hamer or power vatted
wtuarc heater.
Raxinaection of the Service Entratinee Cable, Matarc Booc~ altctationa to receptacles
and lighting fixhtreas due to aiding / sot5t installatioa. Note: New Service
Entrance Cttbla~ will require a separate permit,
Reoonnactlon or new cnrcuit for the replecemeAt of other per:ruwoagy wirod
applisacea 7 fixture.
New aircttit foe tiu aa>aidon of A/C to an ullilvtQual dwelling a3rrr (house or ttte
individual ay.tema ~ s duplex or atondoraimmn), irtelttaiing reeptired eaviax
elaxticiaa] outlets.
au~~
The vahua of this work ie S ' U ~
I horeby verify this work will be performed by 8» employee of this co~m~pany aad furtbcr verify
the soco~ctiort ! installation will be pipette in eomplialzoe with manufacturer and Electric code
roalwra~rtonta.
.9~f,r~,9 y L~ ~yf~ '~Cc s~~ o~
(5ignaturo of car) (Print Name of Oft'i (Date)
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