HomeMy WebLinkAbout0096129-HVAC (furnace & a/c)CITY OF OSHKOSH
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1245 KENTUCKY ST Owner ROBERT ULIZ L ROBINSON JR
No 96129
Create Date 07/25/2002
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. Burner
Chimney Type Chimney A Chimney B Direct Vent Not Applicable
Heat Loss As Approved Existing Not Applicable Value 0
BTU Rate As Per Plan Variable Other Value
Use/Nature
of Work
new a/c. *EIV form
Fees: Valuation $4,350.00 Plan Approval $0.00 Permit Fee Paid
Issued By: ~~~
Permit Voided f
Date 07/25/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
$71.00
Agent/Owner
Address 520 W SO PARK AVE PO BOX 2264 OSHKOSH WI 54903 -2264 Telephone Number (920) 231-5530
~~~.~
Cit)~ of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920)236-5084 O HK 1H
ON THE WATER
;VAC PERMIT APPLICATION
All information after bold categories mus' be provided.
Incomplete applications will not be rro~ Pssed.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
O hkosh WI 54903-1128. Commer<cing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
Ij~~ott are a contractor artici atin in the Per 't ee Account S stem and have ade uate unds check here
i you want this processed through your account
DATE ~ ~ ~
CHEI.<K ~ ALL APPLICABLE
U E CATEGORY
Sir~~le Family ^Duplex
"QI!~[ulti-Family' ^Rental ^Commercial ^Industrial
FUEL. Gas ^Electric_ L7Solid
^Oil ^Solar
.. __ __
SYSTEM New V
OOther
PE
orced Air ^Radiant OSteam ~A/C ^Vent ^Electric ^Hot Water ^Suppl.^Con. Burner
IS CHIMNEY BEING LINED ^No ^Yes -LINER SIZE Rc MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ^Chimney A ^Chimney B ^Direct Vent ^Other
HEAT LOSS ^As Approved ^Existing ^Not Applicable
BTU RATE ^As Per Plan ^Variable ^Other Value
.. 2~'~:
VAi'JL'E (Including labor and alTmateri~ls`including light fixtures) $`'~ ,U
ELECTRICAL CONTRALTO/F~ 8~[7 Electric Insta~~~tion Verification form attac6ed(IFReplacemen-)
Electrical installation ojnr w/replacement equipment shall be done by licensed contractors.
,Replace. .
3/02
07/19/2002 01:19
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FEZ ELECTRIC
Electric Installation Verification
(n (we) >3eez Electric. Inc.
521 W. 12 h Oshkosh WY 54902
have been contracted to perform electric installation work for GartmanMechanical Scrviees,
at the following address: 1245 ICentuckv St.
The nature of the work consists of : (Check One or Describe the Nature of Work)
PAGE 01
® Reconnection or new circuit for replacetttertt Nesting Placer and/or AJC Condenser.
^ Reconnection or new cvrcuit for replacement Electric Water Beater.
^ Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures duo to siding / soffit installation Note: Naw Service Entrance Cables
will require a separate permit.
^ Reconnection or new cira~it for other permanently wired appliances /fixtures.
^ Other
The value of this work is $ 000
I hereby verify this work will be performed by an employee of this company and fluther verify the
reconnection /installation will be done in compliance with manufacturer end Electric code
requirements.
Garv Bid 07/19/02
(Si of Comp car)