HomeMy WebLinkAbout0151601 - HVAC (replace Furnance and AC) 0 CITY OF OSHKOSH No 151601
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1933 KNAPP ST Owner GARYA/CAROLE A PATTEN Create Date 08/09/2012
Contractor GARTMAN MECHANICAL SERVICES Category 512-Ind.&Comm-Both Plan
Inspector Nicole Krahn
Fuel 0 Gas j Oil I J Electric U Solar Solid
System ❑ New Q Replace n Other
Forced Air ❑ Radiant __I Steam I 1 A/C ❑ Vent
Electric ❑ Hot Water Suppl. I Con. Burner I
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 0 As Approved • Existing O Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use/Nature CONDO/REPLACE 60,000 BTU FURNACE AND 2 TON A/C,EIV SIGNED BY SLIM'S ELECTRIC **debit acct
of Work
Fees: Valuation $5,560.00 Plan Approval $0.00 Permit Fee Paid $94.00
Issued By: _n Date 08/09/2012
❑ Permit Voided Parcel Id#1307111000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address PO BOX 2264 OSHKOSH WI 54903 -2264 Telephone Number (920)231-5530
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Aug. 9. 2012 7: 51AM GMS INC No, 9494 P. 1
Division oflnspectiom Services
P.O.$ox 1130 11
Oshkosh,WI 54903-1130
Phone (920)236-5050 '
Fax (920)236-5084
Or.!T YuTER
HVAC PERMIT APPLICATION
information der bold catogories must be provided.
Incomplete applications will not bcprocessed,
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Svioes,PO Box 112 ,
Oshkosh WI 54903-1128. Commencing workwithotit peniiit(s)will result in fees being doubled or$00.00 plus the
iiolmal permit fee,which ever is'greater.
OR •
r, • 1 ' .r. .s, ry 'n•, 1i tr '.e air a ,CC. in vs _m o . 1�a a ae , I. e
a .•n ` da = fre
**Advisbxy-For applicable projects, an Electrical Installation Vailcation form,
Contractor or Homeowner(for hist4ations allowed to be pm fa nzed by the Homeowner)must be submitieeed •
with the permit application. Applications submitted without an EIY wheal such is
processed for Pei tilt issuance and will be retained for completion. xequrred,will not be
•
DATE � �//..k •
J013 ADDRESS
CONTRAC O yr:•.� S.eir..
CHECK W ALL APPLICABLE
13WCATEGORY
Mingle.Family °Duplex °Multi Family ❑Rental °Commercial °Industrial -
DEL t3Qas DElectnic OSolid SYSTEM ONew rr���
1:30i1 la solar ' 'P
DOther
rTY�' - -
'arced Air I:Radiant OSteam g6C ElVesc 1]
Rleolzjc Elliot Water ❑5upp1, DCon,Ban ier
IS CIIIMINEX EEING LINED IRA)OYes
None:All ehimaeys itbatl bn Sized per the MTN being vented MANUFACTURER
galgtiFY TYPE PChimmey A -p(iumey B ! Vent
]CS aged [Other
TU RATEs p Mot Applicable
enable der Value (o of c c,v 1? ', .2 -70 w
DITS TION/SCOPE OF ALL WORK REIN DONE 1-c 1 h ,.{ r rt
VALUE (Including labor and materials)S; •c
ELECTRICAI,CONTRACTOR(for projects not requiring en ETV Form) / c_ipt
D7/01
Received Time Aug. 9. 2012 7 : 48AM No. 0379
Aug. 9. 2012 7: 52AV GMS INC No. 9494 P. 2
1 ; City of Toth
Z1 s aroch AA...1ioe Servkes
v PO Eok WO
OI!>msli WI!4903.1130
•JAil:(u is o 920-1.1e-5o50
Fax 920-2764044
Electric Installation Verification
I(We) SLIM'S ELECTRIC INC.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (may) (State) (Zip Code)
have been contracted to perform electric installation work for �Cj f A ?4,40/1(Name 61party contracted to)
at the following address: 1 33 e 4 a , S?`
(Ad, -:•:•`*,- work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
.)5— Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser,
Reconnection or new circuit for replacement Electric WateiHeater or power vented
water beater.
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 I fixtures.
New circuit for the addition of A/C to an Individual dwelling unit(house or the •
individual systems in a duplex or condominium),including required service
electrical outlets.
Other
The value of this work is$ L7c, Ud .
Thereby 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
requirconerlte.
d v44./,0,9 .}v,,, wiri M/ice
(Signature of Conn/, cer) (Print Name of Offic (Dale)
5102
Received Time Aug. 9. 2012 7 : 48AM No. 0379