HomeMy WebLinkAbout0140612-HVAC (furnace) CD CITY OF OSHKOSH No 140612
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 240 GRACELAND DR Owner NATHAN D /COLLEEN M LOPER Create Date 04/22/2010
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas u Oil U Electric I Solar I Solid
System ❑ New n Replace n Other
u Forced Air u Radiant u Steam U A/C u Vent
L Electric U Hot Water U Suppl. U Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent O Not Applicable
Heat Loss 0 As Approved • Existing 0 Not Applicable Value
BTU Rate D As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $3,290.00 Plan Approval $0.00 Permit Fee Paid $59.50
Issued By: Date 04/22/2010
❑ Permit Voided I Parcel Id # 0618320000
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 (Le. 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.
Apr. 22. 2010 7:58AM GMS INC No. 0399 P. 1
City of Oshkosh ,:_i
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-J130 :.007 •
.....,•. • -
Phone (920) 236 -5050
Fax (920) 236 -5084
•
Pig THE WATOR
HVAC PERMIT APPLICATION
All information after bold categories must beprovided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Commencing work without permits) will result in fees being doubled or $100.00 plus the
norms] permit fee, which ever is greater.
OR
ou , re a co ract,r ,ar 'ci,a - n- i, the :.er it - eAccrtint S tem a have adeauate funds. check here
i ou w is oce d th u our ccount 'i
•
°r*•Advisory - For applicable projects, an Electrical Installation Verification (ETV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for PeunitIssuance and will be returned for completion.
DATE a a d
JOB ADDRESS 2:-10 C- r• -:• c.e le;.
OWNER Nom-. L
CONTRACTOR &im S I r.C, •
CHECK fi3 ALL APPLICABLE
USE CATEGORY
tagingle Family °Duplex OMulti= Family ❑Rental ❑Commercial °Industrial
FE' Dias DElectrie ❑Solid SYSTEM
ClOil la Solar C1New B place
D Other
TYPE
•
S orced Air .DRadiant ❑Steam OA/C ❑Vent 4Eleatrio JHot Water ❑Suppl. ❑con. Burner
IS
Note: CHIMNEY BEING LINED J oo El • - LINER S & MANUFACTURER
chimneys shall be Sized per the BTU's being Vented.
Cmv1AIEY TYPE .°Chimney A •DChimney B Elisirect Vent ❑Other
40..SS .DAs. Approved misting -Mot Applicable
RATE •DAs Per Plan 0 1;11e 1e her Value s O c)OQ 'V _
DESCRIPTION / SCOPE OF ALL WORK BEINGDONE
VAL ' (including labor and materials) $ 3 a cl O - °p
ELECTRICAL CONTRACTOR (for projects not requiring an Mr Fo 5h,.,. 'S EA-c- 4- 1 4 c.
07/07
Received Time Apr.22. 2010 7:58AM No. 0677
Apr. 22. 2010 7:58AM GMS INC No. 0399 P. 2
:1)S Omni MEOW i .
VBort 1130
0Ikb Y►151901 -1130
IN; WA CIF s:az+
�, r� i10
Electric Installation Vesication
I (We) SLIM'S ELECTRIC INC.
• pm-trice Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) • • • .(City) . . (State (Zip Code)
have been contracted to perform electric installation work for
• (Name of party ea»tracted to)
•
at the following address: 4n . CSI Q
• • • (Address where work will be performed)
The matzo of the work consists of (Check One or Describe the Nature of Work)
Rei..don or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection' Or new circuit for replacement Electric Water Heater or power vented
water bye ate i.
Reconnection of the Seivice Entrance Cable, Meter Box, alterations to receptacles
• ..and lighting fixtures due to.siding / soffit installation. Note: New Service
• Entrance. Cables will .require a separate.peimit.
Reoon nocdori or new circuit for the replacement of other permanently wired
• appliances 1 fixtures. • .... •
New circuit for the addition of A/C to an individual dwelling wilt (house or the •
• individual syateins.in a duplexc or condominium.), : including required service
elerarica] outlets: • •
Other
•
The value of this work is $ ! c, D _
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 inanufacntrer and Elect►ic code
requiicrnegts:
•
(Signature of Comp" eel) (Print Name of Offm (Date)
saz
Received Time Apr.22. 2010 7:58AM No. 0677 _ '