HomeMy WebLinkAbout0143734-HVAC (furnace & a/c) l CITY OF OSHKOSH No 143734
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1760 ORCHARD CT Owner MATTHEW A CROWE Create Date 10/20/2010
Contractor GARTMAN MECHANICAL SERVICES Category 502 - Residential -Both Plan
Fuel U Gas Lf Oil L Electric Solar U Solid
System ❑ New i 121 Replace ❑ Other
121 Forced Air u Radiant u Steam ii NC Li Vent
Li Electric U Hot Water Li Suppl. Li Con. Burner
Chimney Type ( ) Chimney A () Chimney B • Direct Vent O Not Applicable
Heat Loss 0 As Approved • Existing O Not Applicable Value
BTU Rate ( ) As Per Plan () Variable • Other Value
Use /Nature SFR / Replace furnace and a/c. Install 3" chimney liner. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $4,950.00 Plan Approval $0.00 Permit Fee Paid $85.00
Issued By: al/t/,. Date 10/20/2010
❑ Permit Voided Parcel Id # 1323870000
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. 20. 2010 8:57AM GMS INC No. 5086 P. 1
- - ..dc.,
Dh'ision of Inspection Services
P.O_ Box 1130 •.
Oshkosh, WI 549 03 -1130
Phone (920) 236 -5050 ;
Fax (920) 236 -5064 '
Oil KWH
HVAC PERMIT APPLICATION QVTMEWAt
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 -] 12g, Co m fencin 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 • co try Ctor . ar iCi , ati i �.
i you th- P'rmi! e co v t S stem , nd have agile, .ate .nds check a •e
nt his r as t ou h our a ccoun t F
°kf` Advisory .Far applicable projects, an .
Co� installations
(for or Homeowner for � ti0 Verification (ETA form, signed by the Electrical
w� the
permit allowed to be performed by the homeowner) must be submitted
P application' Applications submitted without an Ely when such is required, will not be
processed for Pei nAt Issuance and wfi be returned for completion.
t
JOEADDRESS /7((� . rc',..� G DATE %d 3a
O i ri• a,. c
CONTRACTOR .S lh C . .
ClIECK el ALL APPLICABLE
USH CATEGORY
Ogg Family ❑Duplex ❑MultiFamijy fRental ❑Commercial °Industrial
•
FUEL i< °Electric CJS olid SYSTEM ONew ISEp
°Oil OSolar Otherlaa
T�YPF . _.
_!nForcad A ir :CaRadiant C1Steem lti‘C °Ven
t 0.EleCtric [Mot Water pSnppl. DCon. Borer
IS CHIMNEY BEN GG LINED DNo - LIN R STLE 2 � & MANUFACTURER it./ -1- e -- -e-5
Note: All chimneys shalt be sized per the ?3TCI's being vented. •
C1I7tV4NEY TYPE D C finny A . D pima
*411t•;IA,5S A owed B vent 17 0thet
�TII RATE �.� Perham � -�No � Value
DESCRIPTION / SCOPE OF ALL WORK BE]NG DONE A '
•
z__-
VALUE (Including labor and materials) $ 11-0 ° o
ELECTRICAL CONTRACTOR (for projects not requiring an Ell' Form) /
oval
Received Time Oct. 20. 2010 8:56AM No, 3352
Oct. 20. 2010 8:57AM GMS INC No. 5086 P. 2
ary or Oitexik
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as alm& Awls.
PO Bog u30
orb.e WL S4903d130
FYI i An ae� s 2384050
. , Fax 92'45660U
•
Electric Installation Verification
I(We) SLIM'S ELECTRIC INC.
(Electrical Contactor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (City) (Sum) (Zip Code)
have been contracted to perform electric installation work for 1 1 ^ CLH f' ,
(Name of party contracted to)
at the following address: t A O _AAA •
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Hosting Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Notes New Service
Entrance Cab]es will require a separate permit.
Reconnection or new circuit for the replacement of other perrnanattly wired
appliances / fixtures.
New circuit fbr the addition of A/C to an Individual dwelling unit (house or the
individual systems is a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ aC ),oO .
I hereby verify this work will be performed by an employee of this company auod further verify
the reconnection / installation will be done in compliance with manufacturer send Electric code
requirements.
to a� � w
(Signature of . cer) (Print Name of Offc' (Date)
sal
i
Received Time Oct. 20. 2010 8:56AM No, 3352