HomeMy WebLinkAbout0151412 - HVAC (Replace Furnace and AC0 CITY OF OSHKOSH No 151412
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 933 W 10TH AVE Owner MATTHEW/STEPHANIE BALDE Create Date 07/30/2012
Contractor GARTMAN MECHANICAL SERVICES Category 502-Residential-Both Plan
Inspector Nicole Krahn
Fuel 0 Gas U Oil Electric Solar f Solid
System n New n Replace Other
H Forced Air ] u Radiant u Steam H A/C Vent
1 Electric ] I Hot Water Suppl. U Con.Burner
Chimney Type O Chimney A O Chimney B • Direct Vent O Not Applicable
Heat Loss 0 As Approved • Existing O Not Applicable Value
BTU Rate O As Per Plan O Variable • Other Value
Use/Nature SFR/REPLACE 80,000 BTU FURNACE AND 2-1/2 TON A/C, EIV SIGNED BYSLIM'S ELECTRIC **debit acct
of Work
Fees: Valuation $4,840.00 Plan Approval $0.00 Permit Fee Paid $83.50
Issued By: OM Date 07/30/2012
❑ Permit Voided Parcel Id#1302850000
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. 30. 2012 10: 13AM GMS INC No, 9178 P. 1
Division of Inspection Services
I' ��
.O.Box 1130
Oshkosh,WI 54903-1130
Phone (920)236-5050
- Pax (920)236-5084
010 Arffrit
HVAC PERMIT APPLICATION
-Al]information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1128, Commencing work without pennit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is'greater.
.OR
o • .. a C•i • •r • ,r ' I,. , • i e ft
WI 1 Co t have ,:e ua
i ,r . . _„e, , . , �`- v. _ a,, .nd h . 4er_
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**Advisory-For applicable projects, an Electrical Installation V
Ct ntractor or Homeowner(for installations allowed to be performed by the homeowner)mist be wit e(xtcal
ed
with the permit application. Applications subbed without an ET when such is required,wi i not be
processed for Pe` iitIssoance and will be returned for completion,.
DATE 7/?0/1 Z
JOB ADDRESS 3 IA/. L O+'ti
CONTRACTOR �-vr._ r (-n c ,
C KECK RI ALL APPLICABLE
US-CATEGORY
MSingle Family ❑]htplex 0Multi Family Mental 0Commercial I7lndusbiall _
FUEL 16as DB3lectrio EIS olid SYSTEM ONew 141aoc
-00il OSolar
1;Other
Witoreed Air aitediant OSteam 114 Meat
_✓ DEleclnc Cll3ot Water L7SuppL DCou Burner
IS C B EYBL1NG LINED l7No Dyes -LTP$RSIZg 3
Nom Al]e)tinnneys aha11 bo simd per the BTU's being veatad
�.—_ MANUFACTURER ft-4- �- Coo��•
gSTYPE QCh�np�A l Chime Vent COtiter
'�Tn ItA�' -� .O�T�_of A�,p]toable
�7Ae feu'Plan Litt:jaic er Value 8o 1 oQQ , 2 '(a. 70 N
DESLUPTION/SCOPE OF ALL WORK BEING DONE c- .,r-\ -C,.,,,, a--e( 4 /C
c-G
VALUE(including labor and materials) W 0 -
ELECTRICAL CONTRACTOR(for projects not requiring an Ely Form)
07/01
Received Time Jul. 30. 2012 10: 09AM No. 0238
Jul. 30. 2012 10 : 13AM GMS INC No. 9178 P. 2
.1)5 huh Ayes=
PO Bea 1130
Y Othboh WI 5490-1130
104:0111: o16 a 920736,5050
fat Irl0,23030u
Electric Installation Verification
I(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 4o( &!d
q (Name of party contracted to)
at the following address: q 3 3 Lf)
(Address 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 A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable,Meter Box,alterations to receptacles
and lighting fixtures duo 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 J fixtures.
New circuit for the addition of A/C to an rndtvidual dwelling unit(house or the -
individual systems m a duplex or condominium),including required service
electrical outlets.
Other
The value of this work is$ 17S,0f) .
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.
�/ 1
_pi9v1,o/9 ro uH rife 7 /d/J2
(Signature of Comp-;; �� : cer) (Print Name of Office) (Date)
ver
Received Time Jul. 30. 2012 10: 09AM No. 0238