HomeMy WebLinkAbout0145922-HVAC (furnace & a/c) C .) CITY OF OSHKOSH No 145922
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 811 W 10TH AVE Owner RICKEY UDEBRA S GEMPELER Create Date 05/16/2011
Contractor GARTMAN MECHANICAL SERVICES Category 502 - Residential -Both Plan
Inspector Nicole Krahn
Fuel U Gas U Oil Electric U Solar 1 Solid
System ® New 1 n Replace E] Other
u Forced Air u Radiant u Steam u A/C u Vent
L Electric L Hot Water Li Suppl. L] Con. Burner
Chimney Type Q Chimney A Q Chimney B • Direct Vent Q Not Applicable
Heat Loss Q As Approved • Existing Q Not Applicable Value
BTU Rate Q As Per Plan 0 Variable • Other Value 80,000 - 2 ton
Use /Nature DUPLEX (1ST FLOOR UNIT) / REPLACE FURNACE AND NC, EIV SIGNED BY SLIM'S ELECTRIC * *debit acct
of Work
Fees: Valuation $4,795.00 Plan Approval $0.00 Permit Fee Paid $82.00
Issued By: Date 05/16/2011
❑ Permit Voided I Parcel Id # 1306130100
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.
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May. 16. 2011 , 3:24PM GMS INC No. 9642 P. 1
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Division of Inspection Services
1
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) Z36 -5064 '`- ` . } .
HVAC PERMIT APPLICATION o bt THE WATER
-All inforicatioa after bojd categories must beprovided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to C5
Oshkosh WI 54903-112B. Commenoin lHall, �' Room 205 or mailed to Inspection Services, .PO fax 1128,
hoimaj permit fee, which ever is greaterg worwithout Pmt (s) will result in fees being doubled or $100.00 plus the
.OR •
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a tis • • ••• -s r, ir► a ,ce. m S s1e •nd ea
#* .ABvisoxy • For applicable projects, an Electrical Ins '
Contractor or Homeowner (for ' �h0°° Veaf' tcation (EIV) form, signed by the Electrical
(f installations allowed to be performed b the homeowner) must be submitted
with the permit application. Applications submitted
processed for Pexn±Is suance edfo r completion.
an EIV when such is required, will not be
and will be returned fo completion.
S i I w • t �,� _ -; DATE Sy/ i f: ,
JOB AbDRESS
. ,
OWNER Qt. -, y_ -e, r
ror'' xRAGTOR �n ! ,-,.�
CEEECEC I f ALL APPLICA)3LE
t/S4.CATEGORY
'Mingle Fa lex ODup ❑Multi Pamal
Y ORcntal OCommerciel Olndustrial
KIEL OK's-
C]Blectric 17So1id
in Oil OSolar SYSTEM DNew C31Iaoe
17 Other
ther
- �6z Air :t7Radisnt ' C75tearn
Eik CIVent OBleotrie DHot Water DSuppl. OCon, Burner
IS CHBVINEYIJENG LINED OCto OYee
�BR S
Note: All chimnoys shall be sized per the 13TCPs being -�, & MANUFACTURER, -
CUllVINEY TYPE
$EAfi pr ey A 'DClr;iney Vent DOther
f(e Approved xteting C7Not Applicable
4As Per Plan amble
er Vahte c e- 0
DESCRIPTION i scoPl; o� �, wo -� ' 1 2- — 7z"'
RK BEING DONE r ,-,, �- ,
VALUE (Including labor end materiels) y jj . c
ELECTRICAL CONTRACTOR (for projects not requiring Nn EIV Form) -Cif "-) 1` -e.' e -I i •
G
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Received Time May. 16. 2011 3:22PM No.5679
May. 16. 2011 3:24PM GMS INC No. 9642 P. 2
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PO Bat 1130
Odin& WI 7003.1130
!TI : ATI: onlcr 22°.". ow
,,, Fax 92o 216 4
Electric Installation Verification
I(We) SLIM'S ELECTRIC INC.
(El 'cal Contractor Name)
2608 Oakwood Circle Oshkosh WI 549Q4
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installadon work fo
(Name of party contract to)
at the following address: ♦ , ..a. �� .,
(Address where work will M . - • armed)
The
7.
of the work consists of (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condor.
Reconnection or new circuit for replac emettt Electric Water Heater or power vested
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 I fixtures.
New circuit for the addition of A/C to as individual dwelling wet (house or the
individual system in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is 1 f�_
I hereby verify this work will be perforated by an employee of this company and further verify
the reconnection / installation will be donne in compliance with manufacturer and Electric code
requirements.
i '
.i.„... . 4./,0.-9yl,10 4„, itli i l
(Signature of Comp , ; - cer) (Print Name of Office") (Date)
M2
Received Time May. 16. 2011 3:22PM No. 5679