HomeMy WebLinkAbout0147034-HVAC (a/c) (11/ CITY OF OSHKOSH No 147034
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 760 W 10TH AVE Owner WALLACE R/RUTH L HARDY LIVING TRU: Create Date 07/29/2011
Contractor GARTMAN MECHANICAL SERVICES Category 501 - Residential -Air Conditioning Plan
Inspector Nicole Krahn
Fuel 1 11 Gas L Oil U Electric 1 Solar U Solid
System New Q Replace Other
HI Forced Air L Radiant L Steam u A/C Vent
L Electric 1 1 Hot Water U Suppl. L Con. Burner
Chimney Type p Chimney A O Chimney B O Direct Vent • Not Applicable
Heat Loss p As Approved • Existing 0 Not Applicable Value
BTU Rate p As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace a /c. EIV signed by Slim's Electric. * *debit acct
of Work
Fees: Valuation $2,135.00 Plan Approval $0.00 Permit Fee Paid $43.00
Issued By: a>274/2._/ Date 07/29/2011
El Permit Voided Parcel Id # 1305713300
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.
Jul, 29. 20117( 7: 50AM GMS INC No. 1378 P. 1
Division ofrpspectioo Services 1, 4 3 r Of)
P.O. Box 1130
Oshkosh, WI 54903 -1130 _
?hone (920) 236 -5050 ' ,.
Fax (920) 23 6 -5089 ti
-
HVAC P E
• ERMIT APPLICATION Dry T WATER
All information alter bold categories must bcprovided.
• Incomplete applications will not be processed
APPhcation(s) and fee(s) can be brought to City ' Hall, Room 205 or mailed to Inspection Services, $0 Box 1128,
Oshkosh 'WI 54903 -] 128. Cammenain
no permit fee, which ever is greater g � wz � t (s) will result in fees being doubled or $100.00 phis the
.OR -
o e • 0 71" , to •,17 .
you w- 71 f,i. 't II tie '.e mil e r, 'lira o . rccorli S st.r d a e r�e•_a dr
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6 ." Advisory le a projects, or - F applicable
Contractor - F Homeowner applic b p au Electrical Instillation Verification
wig tie a11$t ions allowed to be d by he � form, snmst be the it trtriral
Permit application. Applications submitted by the homeowner) _
processed far Peit it Issnanee and bmiit fo Without en J [y when such is recZnired will not be mrtted
will be retained Ear cornpletioa.
1
JOE ADDRESS (( 7(00 fir, 10 DATE 7 z��
0 . :d' <-. U .cr
•
CON'z'RACI'OR i.
•
CECECX B! ALL APPLICABLE
3 1. TEGORY
dingle FaavMy DDuplex gMulti -Fe y L7Reszta)
ClCommercial C17r,dusttial
FUEL Cl Gas QBlechzc DSolid
-0011 C ISolar y ,�l ,� SYSTEM [7New
TYPE DOther
L7Farced Air °L7ltadiant ClSteam
gh176. ❑Yent OBlectric Dltot water gSuppl, Clean Burnet
IS EYBE]avc LINED CNo °Y
es All chimneys elan be sized per the BTal bei S7ZB /. & ANUFAC7'plt$R
�TEY TYPE 4 �QY A
0 1 Approved s gB QNooteActV� t dOther N7/�-
r en4'ble PP amble
b�'RIP'lTON / SCOPE OF ��� Vs1ue / `/ �
Azx, wOR C �_
VALUE (Including labor and materials ) $ Z %
•
ELECT.RiCAZ, CONTRACTOR (for projects not requiring an EN Form ) -5a
07/07
Received Time Jul, 29. 2011 7:49AM No. 6503
Jul. 29. 2011 7:51AM GMS INC No. 1378 P. 2
Cily ssR
23 $ efo shkC c1i As.... sao Sefvlen
PO Boat 1130
y ( T Oshkosh WI 54903•1130
Im Fax 920.2 .508
Electric installation Verification
T(We) SLIM'S ELECTRIC INC. .
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for _ (4 )a .[ /Q (' P 9 /'nt
/
(N ame of party contracted t
at the following address: ?to (a (t) _ /67--
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
X Recormection or new circuit for replacement Healing Plant and/or ACC 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) fixtures.
New circuit for the addition of A/C to an individual dwelling lair (house or the
individual systems in a duplex or condominium), including required service
electrical outlets,
Other
The value of this work is $ ) 7s, c ,
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 Ind Electric code
requirements.
0 t /
e. 1 V Y/_
(Signature of Comp; i cer) (Print Name of OfFic, (Date)
sacs
i
Received Time Jul. 29. 2011 7:49AM No. 6503