HomeMy WebLinkAbout0152871 - HVAC (Replace AC) i
(9 CITY OF OSHKOSH No 152871
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1517 BURDICK ST Owner RICHARD/SANDRA HACKBARTH REV TRl Create Date 10/10/2012
Contractor GARTMAN MECHANICAL SERVICES _ Category 501 -Residential-Air Conditioning Plan
Inspector Nicole Krahn
Fuel J Gas j Oil ❑ Electric Jj Li Solar 1 ❑olid
System ❑ New 1 0 Replace ❑ Other
Li Forced Air J Radiant _J Steam ✓J NC ! J Vent
Electric u Hot Water Li Suppl. ] Con. Burner 1
Chimney Type 0 Chimney A O Chimney B O Direct Vent • Not Applicable 1
Heat Loss O As Approved • Existing ❑ Not Applicable Value
BTU Rate O As Per Plan O Variable 0 Other Value
Use/Nature SFR/REPLACE 2 TON NC, EIV SIGNED BY SLIM'S ELECTRIC **debit acct 1
of Work 1
J
Fees: Valuation $2,250.00 Plan Approval $0.00 Permit Fee Paid $44.50
Issued By: ain't) Date 10/10/2012
❑ Permit Voided 1 Parcel Id#1501580000
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.
Oct. 8LL. L2012 Jsauosfl 4: 37PM GMS INC No. 0821 P. 1
y U�
Division of Inspection Services (�
P.O.Box 1130 _ �11(�j
posh,WI 54903-1130 "�
Phone.(920)236-5050
Fax (920)236-50)4
kg
HVAC PERMIT APPLICATION 041 WATER
All information they bold categories must be provided.
Incomplete applications vvili not be processed,
• Application(s)and fee(s)can be brought to C5
Oshkosh WI )and fees). ty Hall,Room 205 or mailed to Inspection Services,PO Box 1129,
normal permit fee,which ever great word without p` t(s)will result in fees being doubled or X100.00 plus the
OR .
•
you a acs trestar .•rt' i.at ►: i the P.em' -e ;cc .in t vstem •nd hove ad-.,ate and check hers
'au wa rhi .r• ..e, hr.
. - au- .c 1
'"*-.Advieorp-For applicable projects,an Electrical
Contractor or Homeowner(for installations OuDwedb�����on foam,
signed bye Electrical
will�►e permit application. Applications performed by the ltomeowner)Rmst be sabarittcd
processed erm P `"'' submitted without an Ely when such is required,will'not be
Issuance and will be retained for completion.
■
DATE lb/AAA__
JOB ADDRESS_ 151 r) 3 v.--cl I.at. S4 ,
CONTRACTOR
CSECK Eff ALL APPI,ICARGE
� T'EGORY
Ingle Family OAuplex DMniti-Family DRental ❑Commercial Olndust KIEL does Oc OSolid
'ClOil DSoler 11/ 1 b'YST ONew [ place
,TYPE
VOt
fPorccdAir :l7Radiant OSteem
G r vent tie tic axot water OSnppl. ❑Con.Bumer
IS CEI1Y,Q1iEY EKING L1NED❑No DYes -LINERSIZE
Note:All chimneys shall be lined per the BTU's being ventod wt IV &MANUFACTURER,
_ EY TYPE p
:i' `I SS ey A himney B ODireot Vent °Other "'/A
Til RATE Approved (1Not Applicable
Ns.Peaflam iti7iiiiible 6436r Value
DEsCRIPTI01\'/SCOPE OF ALL WORK$EING DONE �4 r -
VALDE(Including labor and materials) Z 2___.:. ...____-0•c c-'
ELlWIRTCAL CONTRACTOR ACTOR(for projects not requiring an Ery Form) S I
D7/D7
Received Time Oct. 8. 2012 4: 33PM No, 1150
Oct. 8. 2012 4: 37PM GMS INC No, 0821 P. 2
Cszyor0�ko/>'
DI idmollrpmdoaServices
01 t ammo Avear
PO Bon 1170
Olpbah WI 3903-1130
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•
Electric Installation Verification
•
L(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 1 Ch Val Mek()/( A(4,
(Name of patty contracted to)
at the following address: 15'0 5,1 t al i°/( Si
(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 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 fbr 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 S )7 () ) .
1 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.
a .
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(Signature of Cam �,� �� : ter 1 �,��/?
P/ cer) (Print Name of Offic (Date)
sioz
Received Time Oct. 8. 2012 4: 33PM No. 1150