HomeMy WebLinkAbout0143451-HVAC (2 furnace & 2 a/c) l CITY OF OSHKOSH No 143451
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 175 W FERNAU AVE Owner B & P ORDER OF ELKS INC Create Date 10/04/2010
Contractor GARTMAN MECHANICAL SERVICES Category 502 - Residential -Both Plan
Fuel ✓ Gas j Oil Li Electric 1 Solar J Solid
System n New 1 I21 Replace ❑ Other
u Forced Air J Radiant ❑ Steam 1✓f NC u Vent
J Electric U Hot Water l J Suppl. U Con. Burner
Chimney Type ( ) Chimney A () Chimney B • Direct Vent n Not Applicable 1
Heat Loss ( ) As Approved 0 Existing • Not Applicable Value
BTU Rate J As Per Plan 0 Variable • Other Value
Use /Nature Elks Club / Replace 2 furnaces and 2 a/c units. * *debit acct
of Work
Fees: Valuation $12,890.00 Plan Approval $0.00 Permit Fee Paid $189.00
Issued By: a/nt,, [/ Date 10/05/2010
❑ Permit Voided Parcel Id # 1519602400
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 (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.
Oct. 1. 2010 2:50PM GMS INC No. 4641 P. 1/2
City of Oshkosh
Division of Inspection Services
P.O_ Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 0 j' F KC) /( �
ON THE WATER I i
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
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 permit(s) will result in fees being doubled or $100,00 plus the
normal permit fee, which ever is greater.
OR
ou are a contra tor •artici ati - in the Permit - e Account S stem and have ade•uat- nd, he k her -
i nu w• ,is •rocess -d •roufh our ace,., 0
,
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) 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 Permit Issuance and will be returned for completion. ` U
/I �
- DATE 101 1 1
JOB ADDRESS 113 W ` / no
OWNER 1 • • I
-.
CONTRACTOR r yr a v\
CHECK ® ALL APPLICABLE
USE CATEGORY
°Single Family LlDuplex ❑Multi - Family C'tental Commercial ❑Industrial
FUEL f Gas DElectric ❑Solid SYSTEM ❑New Replace
Oil ❑Solar UOther
IkY
Forced Air ❑Radiant ❑Steam ❑A/C DVent Electric OHot Water ❑Suppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MANUFACTURER,
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chinm.ey B irect Vent ❑Other
HEAT LOSS OAs Approved ❑Existing of Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
1 S el' i' TION / SCOPE OF ALL WORK BEING DONE
i A • _ . v • -. _ . A ' 1 • • ,1 .a oc ' _Ii► ! 6
4.
1 t
VALUE (Including labor and materials) $ 1t WA 0'00
-r- -
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form) l � J 0�
Received Time Oct. 1. 2010 2:49PM No. 3070 07/07