HomeMy WebLinkAbout0144618-HVAC (heat pump) 0 CITY OF OSHKOSH No 144618
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1545 ARBORETUM DR #323 Owner BETTY LAWIN LIVING TRUST Create Date 01/12/2011
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel J✓ Gas 1 Oil Li Electric Li Solar ] Solid
System [] New j 0 Replace 1 121 Other
IJ Forced Air u Radiant u Steam lJ NC J Vent
J Electric Li Hot Water u Suppl. I J Con. Burner
Chimney Type 3 Chimney A 0 Chimney B O Direct Vent • Not Applicable
Heat Loss 0 As Approved • Existing 0 Not Applicable Value
BTU Rate ( ) As Per Plan U Variable • Other Value
Use /Nature SFR / Replace water source heat pump. EIV signed by Slimes Electric. ""`debit acct
of Work
Fees: Valuation $3,690.00 Plan Approval $0.00 Permit Fee Paid $65.50
Issued By: Date 01/12/2011
El Permit Voided Parcel Id # 1223560000
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.
Jan. 12. 2011 6:58AM GMS INC No. 7012 P. 1
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130 .1°14
Phone (920) 236 -5050
Fax (920) 236 -5064
vra THE WATER
HVAC PERMIT APPLICATION
All inforiaatiou ater bold categories must beprovided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or maned 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 .
o. !re a on •ct• •ar 'ct• • in; 'n th P• I -e ; cc•nr Sys - • hav- ! •e•uate c, ere
ou -,t t,i • •ce. d th •u -, o ac •u FA
*' .Advisory - For applicable projects, an Electrical Installation Verification
Contractor or Homeowner (for ynstaIlations (EIV) form, signed by the Electrical allowed to be peti'ormed by the homeowner) must be submitted
with tote p ennit application. Applications submitted without an EIV when such is required, will not be
processed for Pe nutIssuance and will be retuned for completion.
DATE //
ITOE ADDRESS IS y 5 A ►--E, ur c 4,...--, * 3a_
° w i g / I R ' La w i . _
CONTRACTOR
CHECK RI ALL APPLICABLE
USE CATEGORY
OSingle Family EDuplex OMulti Family JRental ID Commexcial Oinduslrial
FUEL CI Gas IDElectric ❑Solid SYSTEM DNew Ceeplace
OOi'l OSoler N/A DOthex
•
.TYPE
DForcedAir CIRadiant DSteam OAIC Di'Vemt DBlectric OHot Water DSO_ ppl. OCoa. Burner h e i.,
IS C EM NEY BEING LINED CDNo ClYes - Lfl■lER SIZE p...1
Note: All chimneys Shall be shed per the BTU's being ^--� -- & MANUFACTURER
vented, N /7qt
(71:1I1 EY TYPE CJChizaney A :O . ma ., i ey $ fJDirect Vent C7 Other 4 / • +.A ',L.0$S . Approved : -fi
;r g . C7Nof livable
-$T U RATE -!:]As PerPlan G7Vaiiiible APP
ier Value 2_ - To N
DESCA1pTiON / SCOPE OF ALL WORK BEING HONE ° lo te. 4- 4 -
VALUE Clnelnding labor and materials) Si 3 6)9.0 ' ° o
ELECIRICAI. CONTRACTOR (for projects not requiring en EIV Form) .S I ►,., 's E. It c h.t c.
07/07
Received Time Jan. 12. 2011 6:57AM No.4338
Jan. 12. 2011 6:58AM GMS INC No. 7012 P. 2
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PODIA 1134
Pisa WI a901.1130
OA: An: awe 1P20.2361050
• Fa 924-236.50114
Metric Installation Verification
Imo SLIM'S ELECTRIC INC.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) Pith (State) (Zip Code)
have been contracted to perform electric installation work
(Name o
for A 2A- "I t4r1
f p contracted to)
at the following address: IS_CLUoclUrk_arn
(Address wares 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 AIC 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. Note: New 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 AiC to an individual dwelling unit (house or the
individual systems m a duplex or condominium), including required service
electrical outlets.
Other
The value of this work ie SCb .
I hereby verify this work will be performed by an employee of this company and farther verify
the recormecdon / installation will be done in compliance with manufacturer and Electric code
requirements.
V pAd L (.0.1
(Signature of Comp, ear) (Print Name of Office) (Date)
902
. . _
Received Time Jan. 12. 2011 6:57AM No. 4338