HomeMy WebLinkAbout0152736 - HVAC (replace boiler) CD CITY OF OSHKOSH No 152736
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 448 CHURCH AVE
Owner JOHN J REINDERS Create Date 10/03/2012
Contractor GARTMAN MECHANICAL SERVICES Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
_ Solid
✓ Gas Oil Electric J ❑Solar ] ❑ Solid i
Fuel
System ❑ New
Q Replace I ❑ Other
� -- _
❑ Steam J NC 1 ❑ Vent
❑ Forced Air [Radiant — —
aElectric 1 L] Hot Water _ J Suppl. Litim.Burner
Chimney Type • Chimney A O Chimney B O Direct Vent O Not Applicable
—__ —.--. -- Value
Heat Loss V
As Approved • Existing — O Not Applicable J -
--- -- Value
BTU Rate 0 A Per Plan O Variable • Other
Use/Nature DUPLEX(UNIT A)/REPLACE BOILER,EIV SIGNED BY SLIM'S ELECTRIC **debit acct
of Work
Fees: Valuation $5,985.00 Plan Approval $0.00 Permit Fee Paid $100.00
Issued By:
a v Date 10/03/2012
❑ Permit Voided I Parcel Id#0702340000
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.
Date
Signature
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.
Oct. 3. 2012. 11 : 35AM GMS INC No. 0698 P. 1 D.
i, L' (,ipliKUbn I
.Division of Inspection Services
P.O.Box 3130
Oshkosh,WI 54903-3 130
'...all*.
Phone(920)236-5050
Pax (920)236-5084 0 . ?Dili
ont NE whrat•
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Inoompletcapp]ications will not bcproocssed.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,FO Box 1128,
Oshkosh WI 54903-1128. Commencing work without/ranks)will result in fees being doubled or$100.00 plus the
nomial permit fee,which ever is'greater.
OR .
_. ou a , • .ni f cto .or i.. •n• to it - '.e Ini -a ,cc, Alt v. • o,• r.ave ade• ; - .•; ee, , re
i ,. wa'r h. ,r. - f-, •u- • , , -a , a S
**Ad-vitsury-For applicable projects, an Electrical Installation Verification(ELY)for.,signed by the Electrical
Contractor actor or Homeowner(for installations allowed to be perfaxmcd by the owner)rlmst be submitted
with tie penult application. Applications submitted without an MY when such is reg fired,will-not be
p. ceased for Periiit Issoance and will be retuned for completion.
DATE /D,�/i
JOB ADDRESS 1442 A G k vvr.L
o ;-.. - -
CONTRACTOR MI i \r.t., "
CHECK®ALL APPLICABLE
uWC A� GoR
Mingle Family I]Duplex ]Multi-Family OR.ental DCommercial °Industrial
FUEL Boas DEiectric OSolid SYSTEM °Now Ei+Et‘oe
DOD MS War DOthar,
TYPE
j FomedAir UR diant ,.DSteam C1A1C OVeat DEleetric ILIZiWater 0Suppl. OCon,Burner
is GUMMY BF,1NG LINED tiFi C7Yos -LINER sIZB &MANUFACTURER,
Note:All chimneys shall bo sized per the BTU's being ventod.
CECEMAEI'TYPE PtSimney A •0 ,',,r.eyg ODirect Vent ]Other
" A� '.T. S ,PAsApproved 'z,:xlsttng ;1 J tApplicable
liTU RATE -1:As Per plan iiVaiitible rtes Value 53(OS;000 61/iS
DES TION/SCOPE OF ALL WORK$SING DONE _ c-,,.,.e,,, „lG.r--.
w
VALUE(Including labor and materials) jroo"
ELRCi(RICAL CONTRACTOR(for projects not requiring an E1'V Form)_ sin. c
07/07
Received Time Oct. 3. 2012 11 : 31AM No. 1084
Oct. 3. 2012 11 : 35AM GMS INC No. 0698 P. 2
S, .. _ r
Ch 0O o(i IovOtU
olioa Sutlers
m s ch poAvw
Po Boi 1130
WAYS= O h WI 54903-1130
6 U
Electric Installation Verification
X(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 ga u p 't/Id l e/ .
(Name of party contracted to)
at the following address: _ '5,e' ( A 1(I-ri .
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
XReconnection arnew 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 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 unit(house or the
• individual systems in a duplex or condominium),including required service
electrical outlets.
Other
The value of this work is$ )75,0x) .
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
/,, J. J / ,„,,,,2„,„9 Ya vAl w�y A /0/3/2z_
(Signature of Comp ' car) (Print Name of OfEeet) (Date)
Received Time Oct. 3. 2012 11 : 31AM No. 1084