HomeMy WebLinkAbout0152953 - HVAC (Replace AC) 0 CITY OF OSHKOSH No 152953
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1612 OAK ST Owner JUDITH A ANDERSON Create Date 10/15/2012
Contractor GARTMAN MECHANICAL SERVICES Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate _
Fuel r= as I J Oil -i rj Electric J olar _ 1 Solid
System n New Z Replace Other
]] Forced Air J Li Radiant I EiSteam
ID A/C-- ----- Vent ,
Electric _; Hot Water H Suppl. ] H Con. Burner
Chimney Type ID Chimney A 0 Chimney B 0 Direct Vent • Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable 1 Value
BTU Rate 0 As Per Plan 0 Variable • Other I Value
Use/Nature SFR\Replace AC
of Work
Fees: Valuation -- -- ---------------
$2,090.00 Plan Approval $0.00 Permit Fee Paid $41.50
Issued By: Date 10/15/2012
Permit Voided , Parcel Id#1511280000
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. 15. 2012410 15AM GMS INC No. 0949 P. 1
Divisiam ofIuspection Scrviccs
.P.0.13 �'�
.O.13 ox 7130
Oshkosh,WI 54903-I130 > ' \.Pbomc (920)236-5050
Fax (920)236-5084 =MB
HVAC PERMIT APPLICATION
-All information der bold categories must bcprovided.
Inoomplete applications will not he processed,
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1126, Commencing work without pennit(s)will result in fees being doubled or$100.00 plus the
not permit fee,which ever is'greater.
OR .
o:♦ or- , C. tr•ccta 'or f•_ 'n• to tie ".e r e
ec•un S !em a,, have •, •cote ds here
a._ e lrr:. .r• -s f. ,
P Advisbxy-For applicable projects,an Electrical Installation Vacation(EIY)fora,signed by the Electrical
Contractor or Homeowner(for Installations allowed to be performed by the homeowner)must he submitted
with the permit application. Applications submitted without an EIY wheti such is required,will.aot be
processed for PehaitIssuance and will be returned for campletion.
DATE, loJis-A.2
TO ADDRESS 1 to l D, O u tic..S
OWNE „c,C -
CONTRACTOR ("6‘-511 mac. r .
CHECK El ALL APPLICAXE
USX CATEGORY .
Le Ingle Family ❑Duplex QMniti Family Mental ❑Commerci.al pinduslriai
J(ULt, Dtias ❑Bleotric DSolid SYSTEM QNew EIRTplace
DOil DSolar r•11-.TYPE
.CIForeed Air CRadiart OSteam C ❑Vent ❑Elec Tic OHot Water ❑Suppl, ❑Con.Burner
IS COY BEING LINED QNo 4Yes -LINER__&MA1WFACTUR
Nate;All chimneys shall bo Sized per the BTU's being vented. ev/,.
0mm1 c y TYPE lXhimneyA C7ChimneyB DDirectVen ❑Other "/A-
14f W>5S ,PAS A ed
`- -- Gov ��� .I�1ot Applicable
`BTU RATE 4CIAa Fein Plan liftable
then Value A-iD/U
DESCRIP11O.N/SCOPE OF ALL WORK BEING DONE h-5-- ...,-, A5/C.... -
•
VALUE(including labor and materials) Qom} 'GO
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) ,5:42-, ‘c EEc , �
o7/o1
Received Time Oct. 15. 2012 10: 11AM No. 1236
Oct. 15. 2012 10: 15AM GMS INC No. 0949 P. 2
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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 -) tj(/ An�,i f fa 11 .
(Name of pkty contracted to)
at the following address: 1(/ 2 ()a K ...c-f
(Address where work will be performed)
The nature of the work consists of ((perk 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 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$ /7--eOri
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.
a , ,,. "... ./ ,,,e,„„).....„ r/i i(")//-5 7/2—
(Signature of Comp,"/ " cer) (Print Name of OfficJ I (Date)
sros
Received Time Oct. 15. 2012 10: 11AM No. 1236