HomeMy WebLinkAbout0143672-HVAC (furnace) 0 CITY OF OSHKOSH No 143673
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1509 OHIO ST Owner ANDREW H BOSMA/LISA A DORN Create Date 10/18/2010
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas j Oil U Electric H Solar U Solid
System ❑ New 1 0 Replace ❑ Other
u Forced Air ❑ Radiant ❑ Steam LJ A/C J Vent
Electric H Hot Water
❑ Suppl. 1 1 Con. Burner
Chimney Type ) Chimney A 0 Chimney B • Direct Vent O Not Applicable
Heat Loss K) As Approved 9 Existing O Not Applicable Value
BTU Rate As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $3,280.00 Plan Approval $0.00 Permit Fee Paid $59.50
Issued By:
Date 10/18/2010
❑ Permit Voided I Parcel Id # 1304420000
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. 18. 2010 7:49AM GMS INC No. 5011 P. 1''
Division oflnspection Services � c) V
P-O. Box 1130
Oshkosh, 'W7 54903 -1 13 0
Phone . (920) 236 -5050 " •
Fax (920) 236 -5064
HVAC PERMIT APPLICATION Mt THE WATER
All information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s) and f
Oshkosh ,) a f ee(s 8C be broug to City hail, Room 205 or mailed to Inspec Services, PO Box 1128,
ever Work without pemizt(s) will result in fees being doubled or $100.00 plus the
hommal permit fee, which eve
t are re a o �� r• ctor .. r '
' ,, u . an t is .r, ce edhr.u, h n r th Permit e r =omit ate and have ade• .ate un.ds check here
c.ut
** '`* �.4doisory - For applicable
A rartor or For applicable projects, an Electrical Installation VeriScation
with tie p fellatiorts allowed to be petforaned (E� form, signed by the fit
application- Applications sub by the homeowner) mast be submitted
raid o completion.
as ETV when such is required, will not be
processed for P
wit Issuance and w01 be returned for eoniplt:tiva.
JOB ADDRESS so DATE c$ l o
0 fro S ,
OVVIVER L I % c. v r .,., .
COCTO
CXECIC EN ALL APPLrc >
USE CATEGORY
L9S�ingleY DDuplex DMu1ti Family DRental D
Comtneercial Dlndiyatrial
FTJEL r DBlechic ❑ Solid
'per o Solar STEM ❑1�Tew Iplace
..TYPE - I70ther
!�`arced :DRadiant . Cisteatn dA%C I7Vent d .
Eleo6tc DHot Water ❑Suppl. DCoa. Bm
IS •EI' BE. 7NG LIlVED UK ❑Yes
Note: All Chimneys she1T be Sized per the BTU's b eing yt LINER. .� & IvIANTJFACTURE
OF ALL WORK U A���s :BA .. # � � B ... ,Q�. ir�ect Ve � t .._._.... � .. ............. ........ ..... __ g . ..,.: Y . • t Other
As Per b\ riAble e ° 'cable
DES�Ip'T,ION / SCOPE her Value r � rive.) i3TVs .
RKBEIlVG .
VALVE (including labor and materials) t ° t..,
ELECTRICAL CONTRACTOR (for projects not r
equirittg an EIXr Form) / f _ /-e-- G; yn •
07/07
Received Time Oct. 18. 2010 7:48AM No. 3301
Oct. 18. 2010 7 : 49AM GMS INC No. 5011 P. 3
z� Chock °rte
PO214 1130
•TI - :( J'
, Fa P204364014
Electric installation Verification
I (We) SLIM'S ELECTRIC INC.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (e ity) (State) (Zip Code)
have been contracted to perform electric installation work for s
�
n erne of pasty contracted to)
at the following address:
- -- .. M
(Address where work will be performed)
The nature of the work consists of : (Check One or lobe the Nature of Work)
, Reconnection or new circuit for replacement Heating Plant and/or MC Condenser.
Reconnection or new circuit for replacement Electric Water Heats ar power vented
water heater.
Recorme on of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to aiding / soffit installation. Note: New Service
Enflame Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances 1 Sxttuea
New circuit for the addition of A/C to an Individual dwelling ewtt (house or the
individual systems in a duplax or condominium), including requited service
electrical outlets.
Other
The value of this work is $ LSO P
• 1 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
requirements.
1:.1 P151, A )4NAr Ivo
(Signature of % it cer) (Print Name of (Date)
• Received Time Oct. 18. 2010 7:48AM No. 3301