HomeMy WebLinkAbout0143257-HVAC (boiler) el) CITY OF OSHKOSH No 143257
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 815 ANCHORAGE CT Owner JOHN A C /NORMA J KUMM Create Date 09/22/2010
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel 1.1 Gas U Oil U Electric U Solar 1 ] Solid
System ❑ New 0 Replace ❑ Other
❑ Forced Air ❑ Radiant u Steam u NC r—j Vent
U Electric U Hot Water U Suppl. U Con. Burner
Chimney Type K) Chimney A • Chimney B ❑ Direct Vent ❑ Not Applicable
Heat Loss fl As Approved Existing Not Applicable Value
BTU Rate ) As Per Plan 0) Variable • Other Value
Use /Nature SFR / Replace boiler. EIV signed by Slim's Electric. **debit acct
•
of Work
Fees: Valuation $2,970.00 Plan Approval $0.00 Permit Fee Paid $55.00
Issued By:C/d/ Date 09/22/2010
❑ Permit Voided Parcel Id # 1519730000
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.
Sep. 22. 2010 10:36AM GMS INC No. 4436 P. 1-
va�� vi va LJJ — (2)
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -] 130
Phone (920) 236 -5050 " .
Fax (920) 236 -5084 --
HVAC PERMIT APPLICATION put THE WATER
.All information after bold categories must beprovided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to City Z
Oshkosh WI 5 4903 - 1128. Commencing work th ' n P ts) will result in Inspection bi doubled ed or $ 00.00 p lus the
normal permit fee, which ever is greater. p
OR
ou c re a c tracts •• lie •a in in the Pe nil
' w -nt hi •.r• A au S Slem and •ve ad •ante ands eck he
ce ed hr � - , , r � cc. u ;(
'.wr Advisoxy - For applicable projects, an Electrical Installation Verification (EIV) form., signed by the Electrical
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Contractor or Homeowner (for installations allowed to be pezformed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will rwt be
processed for Pejmit Issuance and will be returned for completion.
DATE `lid / // 0
JOB ADDRESS g 1 S A hjL ,p . .e.- CA-
0 T�c,k k�,.,
CONTRACTOR &-vn I ,
C1ECK 0 ALL APPLICABLE
D U CATEGORY
ingle Family DDuplex DMVlulti -Family y Rental L7Commercial ❑Industrial
FUEL D i S OElectric DSolid SYSTEM DNew
Dail CJSolar D Otila Dail
17Foroed Air ORadiant DSteam DAIC DVent QBlectric [3fot Water DSupp1. DCon, Burner
IS CHIMNEY BEING LINED qpo DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented. �' & MANUFACTURER _
CZIEIlVNEY TYPE Q ey
)lTEA�' L.OS. S :�pAs A pproved n � P ��t vent DOfher
�TdJ RATE DAs Per Plan g . C INot Applicable
dVari'ble kletIlier Value JOS arc c, a 7"r/
DESCRIPTION / SCOPE OF ALL WORK BEING DONE // 1 /-
LGs , C . K r
VALUE (Including labor and materials) 1 21 Q _
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) S1 r t-e e.
07/07
Received Time Sep. 22. 2010 10:36AM No.2923
Sep. 22. 2010 10:37AM GMS INC No. 4436 P. 2
cvticrort�.e
ME Ching urea -
ME Cdrer Aws..
PORos 1130
Ogbsr 9r1 34$1173-1130
571::07/: ao .2164°54'
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Electric Installation Verification •
T SLIM ELECTRIC..INC..
• . Coptffictar
2608 Oakwood.'Circle Os hkosh.. WI 54904
() ` . :. :.., • '( city) • • (State) (Zip Code) • have been contracted. to perform electric installation •wor k' for
rr o of party contracted to) •
at the following address: address: ' •. •1 ••: .• •
:. `. H .
::; (address a►l�ixc•�vark
The nSt1>re:0 die** .: . ' •: .. ...� , : •.. (Che .<..... ..
f consists ei" . ck;One •or,l tribe the Nature of Work)
R e ro eci ion o ne v carcdit'fo ' lacettis f; Plant and/or A/C Condenser,
Aeooanectioa :or :aea� ciratat:for ircplaceo eat Ei ct id Water Heater or power vented
. • ;water lien:: s .
Recur aecaaa:of the'Service Bi ti ce;Caib Me er alterations to receptacles
and lighting r'rehiresdtie.to:sid gi Note: New Seevicc
Entrance CabJcs wi11 rcgmre. separate pecmxt.
Reno ne ne:.,erneai:cuciut for'• the;=epleceenrat of other permanently wired
4 0p0ances / ttu+es. •••• •
New circuit for the addition Of.A/C; tb an individual Witt (house or the
. intfividusl systems a :dupieoc condomia um), including required service
..elecltical.:etttets ':'
•
•
The value ofthis.wod( is •$ 0$ .
I hereby verify .this work vvi]l: be performed by an erniiioyce,of this company and Anther viz*
the reconnactian / installation will be done iii'.campliance with Manufacturer and Electric Ode rognirep�[iute. : • • •
•
(Signature of Camp err) • (Fruit Name .of Offices (Date)
six
Received Time Sep. 22. 2010 10 :36AM No. 2923