HomeMy WebLinkAbout2010-HVAC (furnace) I CITY OF OSHKOSH No 144135
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 368 ROSALIA ST Owner CATHERINE M LINDSAY Create Date 11/18/2010
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas U Oil U Electric Li Solar U Solid
System ❑ New I n Replace 1 n Other 1
u Forced Air _f Radiant a Steam u A/C u Vent
U Electric Li Hot Water u Suppl. U Con. Burner
Chimney Type ( ) Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved • Existing O Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Slim's Electric. **debit acct
of Work
Fees: Valuation $2,890.00 Plan Approval $0.00 Permit Fee Paid $53.50
Issued By: a;414.9 Date 11/18/2010
Ej Permit Voided Parcel Id # 0203930000
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. 17. 2010 8:33AM GMS INC No. 5739 P. 2D
City of Osbkosb
Division of Inspection Services
He' TAi
F.0_ Box 1130
Oshkosh, WI 54903 -I 130
Phone (920) 236 -5050 -
Fax (920)236 -5084 O . O I .
Q.L THE WATER
HVAC PERMIT APPLICATION
- Al information after bold categories mast 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 vo e • eontrae .r •artici•at' - in the _•.ermit : e Account S stem a d have a.de•uate funds eck here
,,u want , s •rocess • • ou: h • ace,
*!� • Ad oxy - For applicable projects, an Electrical Installation Vrs i6cation (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be pm:!nrmed by the homeowner) nmst be submitted
with the permit application. Applications submitted Without art E[V when sash is required, will not be
processed for Pe t tit Issuance and wfll be returned for completion-
, DATE / //, - 7/L o
JOB ADDRESS 3Ce 1
OWNER kw� -b. L cls,�.y
CONTRACTOR G wt S t ■■ti c ,
CHECK El ALL APPLICABLE
US'.E,MTEGORY
0.S Family DDuplex [Multi-Family DRental DCommercial D1ndnstrial
- FUEL [ s []Electric IJSolid SYSTEM Mew glace
l�Oil DSoler ( Other •
•
g7 P' creed Air :DRadiant DSteam t 1A/C •[Went
• OBlochic !].Hot water ❑Supp1. [7Con. Burner
.IS CHIMNEY .BEING LINED D#6 DYes - LIDTER SIZE & MANUFACTURER,
Note: All chimneys shall be razed per the BTU's being vented.
C>E�VIlVE TYPE C1C4mney A •O •; • gib DBirfdt Vent ❑Other
A`LO�SB. Approved = , g .C] Applicable
T�t11 li'E Pea flan7V ' r Value c- ,t3 711
DESCRIPTION / SCOPE 01? ALL WORK BEING DONE 43 c `....� •. -�—
•
VALUE (Tnduding labor and materials) s 0 '
ELECTRICAL CONTRACTOR (for prof ads not requiting an ETV Form) - ��a.w t -e c_
07/07
Received Time Nov. 17. 2010 8:32AM No. 3772
Nov. 17. 2010 8:34AM GMS INC No. 5739 P. 3
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PO Dm WO
Q j ill 5190-1130
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•
Electric Installation Verification
I(Wc) 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 Si • i . I1, *111.4-41
/ (Name of contracted to)
at the following address: —X1 DS °
(Address wise= work will be performed)
The nature of the work consists of (Check One or Naaibe the Nature of Work)
Reconnection or new c rcuit for replacauuat Heating Plant and/or A/C Gardener,
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
_ Reconnection of the Service Entrance Cable, Meter Box, alterations s to receptacles
and lighting fixtures due to siding / sof5t installation. Note: New Service
Bna snce Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances I &tun a.
New circuit for the addition of A/C to an individual dwelling writ (house or the
• individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ r9�c) `" .
I 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 aod Electric code
requirvu eats.
(Signature of ,"� ; cer) (Print Name of (Date)
sAx
Received Time Nov. 17. 2010 8:32AM No. 3772