HomeMy WebLinkAbout0144136-HVAC (furnace & a/c) I CITY OF OSHKOSH No 144136
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1118 W BENT AVE Owner GARY L STAHOWIAK Create Date 11/18/2010
Contractor GARTMAN MECHANICAL SERVICES Category 502 - Residential -Both Plan
Fuel L✓ Gas Oil J Electric J Solar U Solid
System ❑ New [7f Replace ❑ Other
u Forced Air u Radiant u Steam J A/C J Vent
U Electric 1 Hot Water 1 Suppl. L Con. Burner
Chimney Type O Chimney A () Chimney B • Direct Vent O Not Applicable
Heat Loss ,j As Approved 0 Existing 0 Not Applicable I Value
BTU Rate 7 \ ) As Per Plan () Variable • Other Value
Use /Nature SFR / Replace furnace and a /c. EIV signed by Slim's Electric. **debit acct
of Work
Fees: Valuation $5,690.00 Plan Approval $0.00 Permit Fee Paid $95.50
Issued By: Date 11/18/2010
❑ Permit Voided Parcel Id # 1206890000
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. 18. 2010 8:02AM GMS INC No, 5767 P. 1
Lary or ushkosb
Division of Inspection Services
P.O. Box 1130_S� . :. .., ' 9 .T .
Phone (g20?3(r5050 30 •
Fax (920) 23 6 -5084
HVAC PERMIT APPLICATION °''tgr
All information after bold categories must beprovided.
Incomplete applications will a°t be processed.
• Application(s) r b
be b
and fee(s) can e brought to Ci
Oshkosh 'WI 54903-1128. and can b u ' jy , Ro om 205 or mailed to Inspection Services, PO Box 1128,
uomnal permit fee, which ever is greater wok without permit(a) will result in fees being doubled or $100,00 plus the
:OR .
ar• a •n •ct•> ,, lic'.at'ti• ( e Per 11
want th s •r'c e; cc. wet S stem .ndh ode.u•.le u :s check
ed hr. . • h . _ a co. rrt t
r•
''F#thisorp - For applicable projects; an Electrical Ins
Ca�fractor or Homeowner ( installations ' ta�atxen Verification (ETV) form, signed. by the Electrical
with th
e r riit ations allowed to be performed by the homeowner) mast be submitted
p application. Applications submitted without an ETV when such is required, will not be
processed for Pettiiit Issuance and will be returned for completion.
r
J O B ADDRESS 1 I in/. i -e.i.� DATE Ii th % p
. Gr, 5-1-e..6. w-t.6.
CONTRACTOR erfrt S 1 hL .
CSECK Iff ALL APPLICABLE
17SE CATEGORY
C9gingle Family ❑Duplex 4Mult9 Family DReutal DCommerc' .
ial DIudustrial
FUEL poi Q &lectric ❑Solid
.0011 Molar SYSTEM. ❑Now !Mace
F L70�er
orcedAir 1 :1Radisnt p
OVent DEleotric Dot Water ❑Stippl. lJCon, Barren
IS
Note; All CIU EYBEING LINED mill Yes - Lam SIZE
Chimneys sbaf be d per the BTU's bring vented, & MANUFACTURER
IlUEY TYPE fi s A • p eyB e 00 _.
TtJ Fat roy g • 01∎Tot Applicable
=t 1 d V a riab le PP cable
Cr Value GGU 2 71/ h. /
:DESVRIP1ION / SCOPE OF ALL WORK $SINGDOKE rt. I.,- ��- ...,,4- 4 - r1 Ld ♦ T! Lc_
VALUE (Including labor and materials) S SCa e t O ' o U
ELB;G'rRICAL CONTRACTOR (for projects not requiring an EN Form
07/0'
Received Time Nov. 18. 2010 8:01AM No. 3793
Nov. 18. 2010 8:02AM GMS INC No. 5767 P. 2
cboroakoa
ollopsodoa Serviers
315 c1r.E Awing
PO Dal1130
(Moab Wt 54903.1130
OW WA : cw so0 " : "
Electric Installation Verification
i(We) SLIMS 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 L ;[r j , i S
(Name O ' contacted to)
at the following address:
la__LdRikn
-4•
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
Reconnection or new quit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water beater.
Reconnection oftbe Service ice Cable, Meter Box, alterations to receptacles
and lighting fixtures due to aiding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
• Reconnection or new circuit for tho replacement of other permanently wired
appliances) fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
• individual systems in a duplex or condominium), including required service
electrical outlets.
Otbcr
The value of this work is $ c:100 .
thereby m +-t lbc:pet r bygm-e pla ind-furthery .
er fir ........ •-
the reconnection 1 installation will be done in compliance with manafactarer and Electric code
requinanaut,,
OVS116
(Signore of Comp/ % car) (Print Nea of Offic
(Date)
sAm
Received Time Nov. 18. 2010 8 :01AM No. 3793