HomeMy WebLinkAbout0089217-HVAC (a/c) CC ITY OF OSHKOSH N 89217
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 2315 ALLERTON DR Owner THOMASNICTORIA LAST Create Date 09/14/2001
Contractor GARTMAN MECHANICAL SERVICES Category 501 Residential -Air Conditioning Plan
Fuel 17 Gas Oil I Electric Solar 1 Solid
System 0 New 1 7j Replace I Other
IJ Forced Air J Radiant J Steam IJ NC LJ Vent
Electric Hot Water Suppl. I Con. Burner
Chimney Type J Chimney A 0 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss 0 As Approved 0 Existing O Not Applicable Value
BTU Rate J As Per Plan Variable 0 Other Value
Use /Nature SFR/ Replace condensing unit. *EIV form from Slim's Electric.
of Work
Fees: Valuation $950.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: 'K tr Date 09/17/2001
Permit Voided
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
(90. 0 0
Division of Inspection Services
6
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
Fax (920) 236 -5084
N THE WA R
Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
..ATE 4IDA01 l
JOB ADDRESS 15 -A. OWNER L i A
(,01
CONTRALTO Jtbrr\(1
CIRCLE ALL APPLICAB
USE CATEGORY SINGL FAMI DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLACE OTHER
TYPE FORCED AIR RADIANT STEAM VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE 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
NATUR OF ORK:
VALUE (Including labor d materials) 56,
ELECTRICAL CONTRACTOR Lin,
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
‘$0 to $1,000.00 $20.00
$1,000.01 to $10,000.00 $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 $305.00 plus V0.50
per $100.00 valuation or part therepf
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
UILL 4160f
C:uroroatesk
Minas ensrDeelioew Swriow
23 Cluck Away
PO Best 1130
ongam Oskkesh vn 94902.1130
011iee 920236 -SOS
p. walla FOX 03042440N
Electric Installation Verification
(0) (we) Slim's Electric Inc.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for Gartman's
(Name of party contracted to)
at the following address: 1315 Allerton St.
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
X Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance 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 fixtures.
Other
The value of this work is 52.25
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection installation will be done in compliance with manufacturer and Electric code
require o o ents.
410 L
David A. Younqwirth 08/12/01
(Signature of Company T (Print Name of Officer) (Date)