HomeMy WebLinkAbout0100696-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
,Job Address 2120 MINERVA ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GARTMAN MECHANICAL SERVICES
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner DAVID J LOKKEN
Category 502- Residential-Both
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100696
04/08/2003
Other J
Vent J
Use/Nature SFR/REPLACE FURNACE AND INSTALL NEW A/C. *EIV FORM FROM BEEZ ELECTRIC.
of Work
Fees: Valuation
Issued By:
$3,850.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$63.50
Date 04/08/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX2264 OSHKOSH WI 54903 -2264 Telephone Number
(920) 231-5530
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
All info~tion aftor bold categories must be provided.
Inco~lete applicatiom will not be processed.
O O, fH
ON THE W^TER
^pplication(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, P.O 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£ rt)~ are a contractor participating in the PermH _fee Acc. o.!~,ttt $~tem and have adequa_t~_fitnds, ch~ck h~r¢
i_[_),ott want this processed through your account _~_
o\
JOB ADDRESS &\~ ~ ' .
CON'r CXOR
CIIECK [] ALL APPLICABLE
sE CATEGORY
ingle Family IZIDuplex UIMulti-Family I-IRental [-']Commercial [3Industrial
FIJEL [~Gas I-IElectric IDSolid SYSTEM )~INew '~. ~Repla~e
IZIOil [DSolar [DOther
PE
orced Air [DRadiant UISteam I~A/C [3Vent EIElectrio
IS CIHMNEY BEING LINED IZINo [DYes - LINER SIZE
Note: All chimneys shall be sized per the BTH's being vented.
~It°t Water U1Suppl. ECon. Burner
& MANUFA~R
CIIIMNEY TYPE IZIChimney A [3Chimney B nDirect Vent . IZIOther
Il[EAT LOSS [DAs Approved IZIExisting ElNot Applicable
BTU RATE i-lAs Per pla.n EIVariable IZlOther Value ~
DESCRIPTION OF ALL WORK BEING DONE. ~ ~C~ ~!~._~, ~L)~.CI(~ 0~
'rxax. 04¢.
VAI,UE (Including labor and all materials including light fixtures) $ ,_5~.,~- (-~'
ELECTRICAL CONTRACTOR ~~-..,
[] For applicable projects, an E!ectri~ Instal at~n Verification form, signed by the Eleclri~al Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
84/86/2883 23:i3 92023i7255 BEEZ ELECTRIC PAGE Bi
~15 C~u~h Av~w
POBox
Electric Installation Verification
(1) (We) B~z~Electric: Inc.
.5.2.1 W. 12th Oshkosh WI 54902
have been contracted to perform electric installation WOrk for GartmanMechanical,
at the following address: 2,120 Minerva S~reet
The nature of the work consists of: (Check Orie or Describe the Nature of Work)
[~ ~-, Reconnection or newcircuit for replacement Heating Plant and/or A/C Condenser.
n-] Reconnection or new circuit for replacement Electric Water Heater.
n'[ Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due tO siding/soffit installati°n~'Note'; New Service ]Entrance Cables
will require a separate permit,
[] Reconnectlon or new circuit for other permanently wired appliances / fixtures.
n-] Other ~
The value of this work is $~
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
uirements.