HomeMy WebLinkAbout0100418 HOSHKOSH
ON THE WATER
1119 1123 WISCONSIN ST
GARTMAN MECHANICAL SERVICES
Job Address
Contractor
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~ Radiant
Electric I ~J Hot Water
Owner GRANT/GRETCHEN WITHERS
Category 500- Residential-Heating & Ventilating
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100418
03/26/2003
Other J
Vent J
Use/Nature DUPLEX/Replace furnace. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,150.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$38.00
Date 03/26/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX2264 OSHKOSH WI 54903 -2264 Telephone Number
(920) 231-5530
City o f Oshkosh
Division of Inspection Services
P.O. Box 1130
Osl,t:osh, WI 54903-1130
Phnne ~920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
Al! infon~tion after bold categories mu=! be provided.
Incomplete applications w. ill not be. processed.
Application(s) and fee(s) can bc brought to Cit~ Hall, Room 205 or mailed to Inspection Services, P.O Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
a~a'mal permit fee, which ever is ,..exeater.
OR
[LF/. t~ are a contrac.tor ~artici~:t~ing ~q t~.e. .Pertni~_~ ,4ccount,V.~tem anti hav~ adeauate funds, check h~r~
i.]~'pt~ want thi4' processed thr~u£tt .your account [~ ~ '
CtIE .K D ALL APPLICABLE
USE CATEGORY ~
~iji~i~ Family ~DUplex' ~'~'~Multi2F~fily ..... ~Rental '.' "~Commercial
~Gas DElec~ic ~Solid SYSTEM ~New
FUEL
--~Oil ~Solar ~Other
[3Industrial
~Rep!g~e
x,T.YPE
[~orced Air IZIRadiant IDSteam EIA/C I--IVent U1Electric
IS CIIIMNEY BEING LINED IZINo IZIYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CtHot Water EISuppl.
& MANUFACWURER
EICon. Burner
CIIIMNEY TYPE IqChimney'A l-lChimney B EIDirect Vent . UIOther
HEAT LOSS [21As Approved f-lExisting ~Not Applicable
[ITU RATE f-lAs Per Plan UIVariable EIOther Value __
DESCRiPTiON OF ALL WORK BEING DONEf~
VA!,UE (Including labor and all materials including light fixtures) $
ELbCTRICAL CONTRACTOR }%~¢.L
[] For applicable projects, an E!ectric Ins~3jlation Verification form. signed by the Electrical Contractor, must be
attached. If not attached or no~ applicable, a separate Electrical Pcm~it is required.
~/02
83/24/2883 81:53 9282317255 BEEZ ELECTRIC PASE 81
Divieion o~Lm~pe~ 2c~vi~s
~5 Chuf'eh Av~
PO ]~2~ 1130
Electric Installation Verification
(we) Beez El.e. ct.ric, Inc.
~ __Oshkosh WI 54902
have been contracted to perform electric installation work for Cva~_.rnan Mechanical.
at the following address: I 119 Wisconsin.
The nature of the work consists of' (Check One or Describe the Nature of Work)
E]
Rcconnection or new circuit for r~plaeement Heatin~ Plant a~d/or A/C Condenser,
Reconnection or new circuit ~r replacement Elec~c Water Heater.
Reconnection of the Service Br~ance Cable, Meter Box, alterations to receptacles and
lishting fm-tures due to sidin$ / soffit installation. Note: New Service Entrance Cables
will require a separate permit.
Reconneetion or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is SJ_SO.OO
I hereby verify this work will be performed by an employee of this company and fiirther verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements,
(Sit~aun'e of Company O/~cer)