HomeMy WebLinkAbout0083193-HVAC (a/c) 0 CITY OF OSHKOSH N 83193
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 9 & 11 WAUGOO AVE Owner REIMER FAMILY TRUST Create Date 11/30/2000
Contractor GARTMAN MECHANICAL SERVICES Category 511 - Ind. & Comm -Air Conditioning Plan
Fuel I✓ Gas Oil Electric Solar Solid
System I New ✓ Replace Other
Forced Air 1 Radiant Steam ✓I A/C 1 Vent
Electric Hot Water Suppl. Con. Burner
Chimney Type ) Chimney A ( ) Chimney B ( ) Direct Vent ( ) Not Applicable
Heat Loss \) As Approved O Existing ( ) Not Applicable Value
BTU Rate O As Per Plan (-) Variable O Other Value
Use /Nature 'UMM / REPLACE NC
of Work No electric permit required- received installation verification signed by Slim's Electric)
Fees: Valuation $4,500.00 Plan Approval $0.00 Permit Fee Paid $72.50
Issued By: 3m Date 11/30/2000
J Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 520 W SO PARK AVE PO BOX 2264 OSHKOSH WI 54903 - 2264 Telephone Number (920) 231 -5530
'7 4'50
(;;) Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
ON THE WATER Fax # (920) 236 -5084
Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 11 114 'u0
JOB AD ESS
1
OWNER
CONTRACTOR , S a�
CIRCLE ALL APPLICABLE
USR CATEGORY SINGLE FAMILY DUPLEX MULTI - FAMILY COMMERCI INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM NEW REPLAC OTHER
TYPE FORCED AIR RADIANT STEAM A/C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED LINER SIZE MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE OTHER VALUE
NATURE OF WORK:
VALUE (Including labor and materials) $ '45C. QOC)
ELECTRICAL CONTRACTOR
Electrical install#tion of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 to. $1,000.00 $20.00
$1,000.01 to $10,000.00 $20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000.00 $155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 $305.00 plus $0.50
per $100.00 valuation or part thereof
•
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fed, which ever is
greater.
4 T■W OplAIAZI
City of Oshkosh
Division of Inspection Services
215 Church Avenue
. ®
PO Box 1130
Oshkosh WI 54902-1130
OJFIH
Office 920 - 236 -5050
ON THE WATER Fax 920.236 -5084
Electric Installation Verification
(I) (We) S (.,) m's" 2 4G 'FR / L ' 6 ,
(Electrical Contractor Name)
Z co4r o 6waa4O c>te. OSh sA I. s
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for GO r � 7 S ,
(Name of party contracted to)
at the following address: 1/ 6Uci o q pd (J v .
(Addrkis where 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
P g A/C Condenser.
Reconnection or new circuit for replacement Electric 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 other permanently wired appliances /fixtures..
Other
The value of this work is $ Ci - / / • 9 �
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 and Electric code
requirements.
/ j ,./ d
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Si ature of Com cer) � P ) (Print Name of Office (Date)