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HomeMy WebLinkAbout0144137-HVAC (boiler) 0 CITY OF OSHKOSH No 144137 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 406 DAKOTA ST Owner MICHAEL J LASFALK Create Date 11/18/2010 Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan Fuel I✓ Gas U OiI U Electric 1 Li Solar Solid System n New 1 0 Replace 1 ❑ Other ❑ Forced Air J Radiant ❑ Steam ❑ NC ❑ Vent U Electric I✓ Hot Water U Suppl. U Con. Burner Chimney Type 1() Chimney A U Chimney B • Direct Vent 0 Not Applicable Heat Loss () As Approved • Existing 0 Not Applicable Value BTU Rate 1) As Per Plan U Variable 0 Other Value Use /Nature SFR / Replace boiler. EIV signed by Slim's Electric. * *debit acct of Work Fees: Valuation $2,850.00 Plan Approval $0.00 Permit Fee Paid $53.50 Issued By: Date 11/18/2010 ❑ Permit Voided I Parcel Id # 0603340000 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. 3 usbxose rs r \ Division of Inspection Services • Box 1130 " Oshkosh, W1 54.903.1130 Phone (920) 2305050 ' = Pax (920) 236-5084 ; THE WATER HVAC PERMIT APPLICATION ON 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 I , ar a c, t •ct, ,, rtic . ,at'i. 'n t, P r tit - e ;cc, 1S tem , dhave ;de,uat- fund ch -ck he•- wan 1 i •r,c -d hr, - -h au a o nt '• fe Advisory - For applicable projects; an Electrical Installation Verification Couttactor or Homeowner for installs. • (ETV) form, signed by the Electrical r rit (for al lowed to be p =framed by the homeowner) must be submitted • with the P application. Applications submitted without an EV when such is required, will not be processed for Pe ft Issuance and will be returned for completion. ■ DATE / / / /f//o JOB ATDRESS 1 0 c., �•G, COAT- RACTOR CHECK Ea ALL APPLICABLE USE CATEGORY ogle Family ❑Duplex ❑Multi Family DRental ❑Commercial ❑Industrial FUEL OBlectric olid SYSTEM '10011 o Soles ONew emplace TYPE D Other . J DForced Air : iant °Steam AA/c DVent IDEleotric '2Hot Water °Suppl. °Con. Burner Note: E13111NEY BEING LINED L�OYes - LllgR SIZE chimneys libel be Sized per the BT[T's being MAI�IIFA CTIJRBA Ong vented 2NEY.TYPE ocl,ey A ...... © ',LOSS ; DAs4 roved g O o Vent C70ther ETU RAT; )' P lsa UV tiab e .. 'OP GEFer Applicable ceble 901* `o tP Tv DESCRIPTfON / SCOPE OF ,: • ALL WORK )3EINGDONE ' VALUE (Including labor and materials) $ S U c o ELECTRICAL CONTRACTOR (for projects not requiring en EW Form) s 1 S Lit "'� Gtr C 07/07 Received Time Nov, 18. 2010 8:01AM No, 3793 Nov. 18. 2010 8:02AM GMS INC _ No. 5767 P. 4 cayoro+wo ® Midas ofreetles Services ro aatew Oda& WI 34 903-1130 •71 (w71: , Fie mar: Electric Installation Verification r(We) SLIM'S ELECTRIC INC. (Electrical Contractor lame) 2608 Oakwood Circle Oshkosh WI 54904 (A) (City) (Sue) (Zip Code) have been contracted to perform electric installation work for I �a►I 1_! . 141 (Name of patty co , L cd to) at the following address: 0 1\all (Addresswhere 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 AA: Condenser. Reconnection or new circuit for replacement Electric Water Hewer or power vented wafer neater. Reconnection of the Service ice Cable, Meter Box, alterations to receptacles and lighting fixtures dux to siding / soffit installation. Note: New Service Entrance Cables will requite a separate permit. Reconnection or new circuit for the replacement of other permanently wired appliances / fixtures. New circuit for tie addition of A/C to an individual dwelling wit (house or the individual systems in aduplex or condominium), including required service electrical outlets. Other The value of this work is S >��c� I here ve f da wdllbe ..perfoaned- byaa-anployee+of tbisoompanyn further verify • the recoaaection / installation will be dope in compliance with manufacturer and Electric code requirements. i,G�s9 Yoko, tt\9\10 (Signature of Comp, ; eer) (Print Name of Offload (gam) s/oa Received Time Nov. 18, 2010 8:01AM No. 3793