HomeMy WebLinkAbout2012 - HVAC (replace furnace) 10 CITY OF OSHKOSH No 153216
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 955 ADAMS AVE Owner KRISTINE/DONNA VAUGHN Create Date 10/26/2012
Contractor GARTMAN MECHANICAL SERVICES Category 5.00-Residential-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel U Gas Oil � ❑ Electric A Solar 1 0—Solid _I
System ❑ New 1 Q Replace
- ] ❑ Other
LT-Forced Air 1 Q Radiant
Steam A/�
Electric 1 Hot Water 1 ESupp. Q : Vent 1
l ] LTC on. Burner
Chimney Type Chimney • Chimney - - - _ -_
B 0 Direct Vent 0 Not Applicable
Heat Loss 0 As Approved • Existing 0 Not Applicable I Value
BTU Rate
As Per Plan 0 Variable • Other Value 80,000_
Use/Nature SFR/REPLACE FURNACE, EIV SIGNED BY SLIM'S ELECTRIC **debit acct
of Work
pP $0.00 Permit Fee Paid
Fees: Valuation $1,800.00 Plan Approval $37.00
Issued By: L- Date 10/26/2012
❑ Permit Voided] Parcel Id#1607850000
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. 26. 2012-` 909AM GMS INC No. 1191 P. 3
Dic•ision DfRgspeCtian Sarvaocs
P.O.Bor7130 9(31/Q)
Oshkosh,WI 54903-1130 j
Phone (920)236.5050
Pax (920)236-5084
HVA ' wArErt
C PERMIT Do THE
MIT APPLICATION
-All in-foliation after bold categories must beprovidty
Incomplete"Audi=will not be processed,
• Application(s)and fee(s)can be brow
Oshkosh on 54903-1128. Cow brought to Ci �Room 205 or mailed to Inspection
uomiej Commencing work without permit{a)will malt fees being doubled or$100.00 plus the
Permit fee,which ever is greaten.
-OR -
1'• are • co tr-ctoY ,. /' t•a n. in he pant!
r apL it t t ,r,
r 'cc,
es d hr. ., t U eA Conn vat• z aid have •de•uoe- un•s the here
'•tie,A.dgisorT-For applicable 'eets ro
p do Electrical Iustallatioxt Verification(XIV)form
CD�actor nx$omeowrter(for'
wig meter penult allowed to he perJ'ozmed r d by the jtte,Jrical
vtia t
processed for p ?li on. Applications submitted without an the bmareowq be submitted
gut Issuance and�be reined for co when such is required, will-not be
mpletion
J ADDIU DATE o �2� i�
B
OVINUR 1 C7 v S o '
COPIRACfo Cr'h"-g r.c_ ,
C OCK l'1 ALL APPLICAILE
USE CATEGORY
❑Single Family dDriplex C1Mu1ti Family
FuEL �` DCamtn�l DIndns(risI
D2� UE1ec(ric °Solid
j70iI LISolar
SYSTEM lJNew
Doter
Worted Aa :�din lie
•L7Ste
am Cie Rvcnt
LiElectric besot Water ❑Suppl. Con Buner YB G L11EDr�dY
Note:All eys shall be sired pr the BTU's yank--��&MAI�AJFAG'T'(TR$R
�4C» s d ey A _PehimaeyB
Witr
RATE AAs ApProved ODirect Vent ppta
tAi Per Plan 10 Vmi ible ;7Not Applicable ale
DES PTION/SCOPE OF ALL WO ��?er Value U cc,�
WORK [�•-cam. - -
VALUE(�ciud.P,lg labor and materials)S 0
ELIXTRICAL CONTRACTOR(for projects not requizingan$IV Fa
D7/0'
Received Time Oct. 26. 2012 9:05AM No. 1415
Oct, 26. 2012 9: 09AM GMS INC
No. 1191 P. 4
City or°.kik,n,
Z5C ch Services
PO Bac WO
°ben wI 1149034
130 il:(.7 rec. "6-TorElectric Installation 'Verification
r(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 a S
(Name party retracted to)
at the following address: S-5 S
(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 1 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$ J%;oa •
I hereby verify this work will be performed by an employee of this company and further verify
the erection/installation will be done in compliance with manufacturer and Electric code
requirements.
,..54./.0,4 v,ar ir/I
(Signature of Comp/% ' car) (Print Name of Offs
(Hato)
sAT2
Received Time Oct. 26. 2012 9: 05AM No. 1415