HomeMy WebLinkAbout0144064-HVAC (furnace & a/c) I CITY OF OSHKOSH No 144064
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1960 CLIFFVIEW CT Owner LEONARD J HERRICKS Create Date 11/15/2010
Contractor GARTMAN MECHANICAL SERVICES Category 502 - Residential -Both Plan
Fuel U Gas U Oil U Electric 1 j Solar H Solid
System ❑ New 1 121 Replace a Other
U Forced Air u Radiant u Steam 4 A/C j Vent
1 Electric ❑ Hot Water Li Suppl. Li Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss j As Approved • Existing 0 Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other 1 Value
Use /Nature SFR / Replace furnace and a /c. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $6,780.00 Plan Approval $0.00 Permit Fee Paid $112.00
Issued By: a/1 -'4/ ' Date 11/15/2010
❑ Permit Voided Parcel Id # 1525940000
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.
Nov. 12. 2010, 4:12PM GMS INC No. 5681 P. 1
Division ofInspection Servjccs
P.O. Box 1130
Oshkosh, WI 54903 -1130
...... 0
Phone (920) 2 36.505D
Pax (920) 2 36 -5084 �.;.. .
-1 K0/1-1
HVAC PERMIT APPLICATION �V THE WATER
All information after bold categories must be provided.
Incomplete applications will not be processed,
• APP7i�hou(s) and f
Os pplic h on 54nee(s 8 be brought to City Rail, Room 205 or mailed to Inspection Services, PO Box 1128,
normal permit fee, which eveer eater work withontpemrit ( will result in fees being doubled or $100.00 plus the
OR .
ou • re , C. • relator • •ri'ci•at'n in th • Per if , e Accoun 3 tem an
ha e ade u. to ?Ids check ere
r want h' .ro e . ed th ou-h o r ac .o 1
°"-t •Advisoxy - For applicable projects; an Electrical
Contractor or Homeowner for installations Verification (ETV) form,
CO lac (for allowed to be ' mist by tube Electrical
permit application. Applications PeZ EI d by the ach is equir d, will be submitted for Pe nitlssoance sabm for completion.
io ETV when sack is required, wiI1 nOt be
and wit be retained for completion.
J013 ADDRESS I [o p Gt1� DATE // Lo
oWATER Le [-tr Ni
CONTRACTOR 6-PA S lac,
CHECK Leff ALL AFPIJCA;gLE
USE _CATEGORY
►11 .8' e Fl y 4 Dupaer C]Multi- Family ORental ❑ Commercial
•
olndustrial
rum, c13 ❑Electrio ❑Solid
471011 DSolar SYSTEM ONew Glace
POther
..�edAis :ant . 178te =
LS dVeat dElectric Mot Water ❑Sappl, gCou. Burner
Note: V h ba LINED 6 0Yes - LThnitSIZE &
P etc ./3117's being vented. � MA1V [TFA(,"I'[)RER _
.'.Afi TYPE : ApprovedQ?unneJ' A EIC�, -B Ven . .
rrei,t t dOther
.011:7 RAit a L Pet P lan ng INot Applicable
E7Veri�bleer Value /ac.
OF
DE<CRIPI�ON /SCOPE Cite) y ' 7a
•
ALL a'pRKBEIIVGDONE /2e.. e-e---d
VALUE (Including labor and materials) 5i 790 . a cj
ELECTRICAL CONTRACTOR (for project not requIring an EW Form)
07/07
Re Time N ov, 12 2010 4:11PM No.3720
Nov. 12. 2010 4:12PM GMS INC No. 5681 P. 2
CMyot04406
9 elope/doepe/doe Semi=
ISCIvreh Mimes
Po Ikm H30
t�J � J allk! f2a t30
rem 4
Electric Installation Verification
T(We) SLIM'S ELECTRIC INC.
(Electrical Contractor Name) �"-
2608 Oakwood Circle Oshkosh . WI 54904
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for : tom
(Name of party contracted to)
at the following address: A
(Address 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 Heating 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. Not Now Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances) fixtures.
New circuit for the addition of A/C to an individual dwelling rant (house or the
individual systems in a duplex or condominium), including required service
electrical outlets,
Oar
The value of this work is S v 00 ,
x-hereby-vaify -this work -will -be performed-by u e
thereconnexaion /' y' rrrployee�oftl >iSCx:mPmry� °tit�er verify • .. .._........:.
installation will be done in compliance with manufecwrer and Electric coda
requirement&
YaiikA t(ligi (6
(Signature of Comp ca) (Print Name of O (Dee)
sroz
Received Time Nov.12. 2010 4:11PM No.3720