HomeMy WebLinkAbout0100823 HOSHKOSH
ON THE WATER
.lob Address 1524WISCONSIN ST
Contractor GARTMAN MECHANICAL SERVICES
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner MARTHA A SKRUBY
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ 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
100823
04/15/2003
Other J
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$2,860.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$48.50
Date 04/15/2003
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
Divisiou of Inspection Services
P.O Box 1130
Oshkosh, WI 54903-1 i 30
P%ae (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must bo provided.
Incomplete applications w. ill not bo processed.
O -KGfH
ON THE WATER
· A pplication(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, PO 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
lf ),o~ are a contractor participating in the PermH fee Account System and have adeouate fitnds,
i~_A, ou want this processed through your account ,[~
CI[ECK [] ALL APPLICABLE
,xU S.E CATEGORY
!~ingle Family
\
FUEL ~'Gas
I-IOil
FIDuplex [3Multi-Family EIRental k-JCommereial Ellndustrial
IlEiectrio ElSolid SYSTEM, F1New ~Rep!~oe
IlSolar FIOther \ -
TYPE
X~Vorced Air IlRadiant IlSteam Ii,adC nVent EIElectrio
IS (?HIMNEY BEING LINED F1N~', OYes - LINER SIZE.
Note: Ali chimneys shall be sized per the BTU's being vented.
IlItot Water F1Suppl.
& MANUFA.CWLmER
nCon. Burner
CIIIMNEY TYPE IlChimney A l-IChimney B IlDirect vent . IlOther
}[EAT LOSS nAs Approved IDExisting I-INet Applicable
ilTU RATE riAs Per Plan IlVariable I-IOther Value
DESCRIPTION OF ALL WORK BEING DO ~(.h.~ ~ (,~ c._S._~- .. rX...}-N_D~+.. ~_&'x
VALUE (Including labor and ali materials Including light fixtures) $~
ELECTRICAL CONTRACTOR'~-")_~_P-. q ~
[] For applicable projects, an E!ectri¢ Insi~.l~tio'h Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
e/o2
' ~ 04/il/2003'00:35 9202317255 BEEZ ELECTRIC PA~E 01
Electric installation Verification
(I) (We) B_e_ez Electri¢.3a_c.
~..~i W. 12th Oshkosh ~___ 549_0_2
have bccn contracted to perform electrio installation work for Gar~an Mechanical,
at the following address: 1524 .W_!.sconsinS_t.
The nature of the work consists of: (Check One or Describe the Nature of Work)
Recormection or new circuit for replacement Heating Plant and/or A/C' Condenser.
R, econnection or new circuit for replacement Electric Water Heater.
B, econnection of ~he Service Entrance Cable, Meter Box, alterations to r~ceptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require a separate permit.
lkeconnection or now circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $1,50.00
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in complianc~ with manufacturer and Electric code
requirements.
(Signature of Company Officer)
04111/03.