HomeMy WebLinkAbout0145321-HVAC (boiler) e ll) CITY OF OSHKOSH No 145321
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 840 W SOUTH PARK AVE Owner GLEN H /JEAN L STEINBRECHER TRUST Create Date 04/04/2011
Contractor GARTMAN MECHANICAL SERVICES Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas Li Oil U Electric Li Solar L Solid
System (l New 1 4 Replace 1 ❑ Other 1
Li Forced Air U Radiant U Steam U NC Li Vent
Lf Electric U Hot Water 1 1 Suppl. Li Con. Burner
Chimney Type ( ) Chimney A • Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss ;_) As Approved • Existing 0 Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use /Nature SFR / Replace boiler. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $2,800.00 Plan Approval $0.00 Permit Fee Paid $52.00
Issued By: (rd. Date 04/04/2011
Ei Permit Voided I Parcel Id # 1306980400
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.
Apr. 4. 2011 :51AM GMS INC No, 8742 P. 1, �\
Division of Inspection Services U V
P.O.Box1130
Oshkosh, W1 54903 -1 13 0
Phone (920) 236 -5050 " . .
Fax (920) 236-S084 _ ,Z u
Of &1. 1
HVAC PERMIT APPLICATION WOLTER
All iaforinatiDn after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to Ci
�'
Oshkosh 'WI 54903 -1128. Comm Hall, Room 205 or mailed to Inspection Services, p0 Box 1128,
aomral p it fee, which over is greater. �`'° without pmt {s) w�l result in fees being doubled or $100.00 plus the
DR
.r ou • re • c•nt ac or , art "ci•.ti - i
I '• , ant thi. •roc- see thr•u.h t eP.er it a Ac ou t S ste and have rde,uo. e fun check 're our a. co nt
•
4.1r Adoisbzy* - Fox applicable projects; an Electrical
Contractor or Homeowner (for ' � Verification (.EIy) form, signed by the Elecxxical
with the ( installations allowed to be performed
peanit application. Applications by the such is required, d, w ll not be t
processed for P Is submitted completion.
io ETV When sarh is required, will not be
seance a nd w�1 be retnmed for c
JOB ADDRESS k 1 O i v, Sc.-44, a,.- DATE ���ii
OWNER 44. S ; 4,_
coNtgACrOR o /, 4 , -
c ECK E'1 ALL APPLIC.A;BI
USE CATEGORY
'ingleFamily I7Dupler gMulti
Y ClRental CJCommercisl ❑Iudushial
P'CIEL ❑Electric Li Solid LINew bOi1 Molar SYSTEM b Cher ❑Replace
TYPE
!]Forced Air :pg
diant C1Steam ❑AIC PVent nalectric
](S C-�'Il� gEIlVG 'Cot Water i'7S�pp1. ❑Con. Burner
Note: All INE IUD I ❑Yes - LIN$dt SIZB
chimneys shall be sized per the BTU's' being ventod & M•41�UF'4CI'[JRli� _
CH pMEY TYPE ❑Chimne A
� �1�`. LQ PAW • �mney B dI)ireCt Vent i7
R ATE A P plea g t71■Tot Appli Orhvr
cable
� erii ble thDfller Value /as; aa-a aTLl
DES TION / SCOPE OF ALL WORK BEING DONE
VALUE (Isiclnding labor and materials) $ 8D0' ° °
ELECTRICAL CONTRACTOR (for projects not r � L
o4mring ern EIV Form) �2 �lt�'! G
07/07
Received Time Apr. 4. 2011 10:50AM No.5155
Apr. 4. 2011 10:51AM GMS INC No. 8742 P. 2
vk oroaike&
Divans allispoxion Services
71
PO Ben 1130
Od a & wT 549o3 -m0
WI: AM *26.2364°5°
fax X64099
Electric Installation Verification
r( Je) SLIM'S ELECTRIC INC. .
tEIectrieal Caat ractor Name
2608 Oakwood Circle Oshkosh WI 54904
(Address)
(City) (State) (Zip Code)
have been contracted to perform electric installation work f
cs
(Name of party contracted to)
at the following address: �`' l JLJ •
(Address where work will be performed) --
The native of the work consists of (Check One or Describe the Nature of Work)
__. Reconnection or new czrcuit for replacement Heating Plant and/or A/C Condenser.
- Reconnection or new circuit for replacement Electric Water Heater or power vented
wafer 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 I fixtures.
,____ New circvlt for the add tlon of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including wed service
electrical outlets,
Other
The value ofthis work is $j1 —.
I hereby verify this work will be performed by an employee of this
the et�on / installation will be done in company and further verify
requirements. compliance with and Electric code
(Signature of Camp „ j ; cer) „, /,O, y U� l r f �t l
�/ (Print Name of i (Date)
sier
Received Time Apr. 4. 2011 10:50AM No, 5155