HomeMy WebLinkAbout0155554-HVAC (a/c) �
: � C�� OF Q$H�(Q$H No 155554 =
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1001 BONG CT Owner ROGER R/LINDA M ANDERSON Create Date 05/10/2013
Contractor GARTMAN MECHANICAL SERVICES Category 501 -Residential-Air Conditioning Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric Solar Solid
System � New I �✓ Replace I Other I
Forced Air Radiant Steam � ✓ A/C _ �, �] Vent _
Electric Hot Water �Suppl. Con. Burner
Chimney Type Chimney A � Chimney B � Direct Vent � Not Applicable i
HeatLoss AsApproved � Existing � NotApplicable � Value
BTU Rate As Per Plan � Variable � Other Value
Use/Nature FR/REPLACE 2 TON A/C,EIV SIGNED BY SLIM'S ELECTRIC "debit acct
of Work
,
I
�
i
� __ ,'�
Fees: Valuation $2,160.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: ��l Date 05/10/2013
❑ Permit Voided I Parcel Id#1109300000
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
AgenUOwner
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.
May 9 2013�� 4: 18PM GMS INC No. 5027 P, 1
• �i��sion�rdnspcc�on scrviccs �
P.O.Bax1130
pshlwsl�,WY 54903=1130 :.
pb.one�(9?0)23�SOSD '
Fex (920)?36-SUBA '��^ -., -
�p���
HVAC PERIN�T APpLICATION ��
�All info�oa efta bold categories must b�providcd,
rncomplcteepplicatjams wi1J nnt beprocas�d,
� .Applicetion(s)and fee(a)can be brwght to(�ty g
Oshkosh WZ 54903-112B. Comm �ROOm 20S oz�ma�lr�to Jnspecaon Servir.es,PO�ox 1126,
nouual pea�it feE,wbach ever is' ���rk without pe��(a)qvill te�nit in fees being dwbled or$100.00 plus the
. O� geatea.
v u ar a Co tr cior
. . f ti� '' t e P.e
i �nu wa� t i r e d.. hr, u a _a .�f e ce Wnl,Syale o ho e ad uai� v.n s. h.eck e�e.—.
'k'''.Ad�visoxp_For epplicable projeda, an Euc�
Cax�actor or Home��na for ��'°YadScabion(k��uim,sa�ned by the�,lectuicai
� . �atiaas elluwed.to T�e
wi.�the�P�ii epplic�tinu,. Appli�ions sab P e.�formed bp�ie Iwmeowua�mnat be snb�ttc� •
pzoc�saed�iorPe`'tmrtiaa'uaace sud ��°�t en ETYwhe.asachis '
• �1 be re��r���� ��,�-z�wt be •
� .
JOB.A,D DdTE .3� 4 •
. I�RESS 0�1� .3v�,e° �.,
��N�R � � A.t�rl� .�i
CONTRAC'.I'OR ���fY,+ � ,
C,�GK��LI,AppY.TCABT�E �.
�1S�',CATEt�RY
C9�S`ing]e Fearily qD�plex QMz�tri Fe�i�Y nRentel '
_ pCo�� p��
� � �x�ic OSolid �
OSol� �1�' .Cr�plsoe
.�� noe�
DForcaa.A� :�tsa;an.t �r St�a, F3�lc pID�;o
�� QxTot�Peter ❑
�6 C�IJNEY$EIlVGx,II1tED pNp l7YES ..L?1�� �1. ❑�on,Bi¢ae�
No�e:All chi�aneys s�al1 be pzalperffie�Ttl's bangv.eated, Rr�i�-''&MA1�I1FAC1'[IRBR
.�._.�SZ'YpE �C�nmeyA �p��,B ��V� � �
�...� LIAs,Ap�os►ed , � � Othea l�t
'�T� �7As�Per Plea � ��li�blo
ea�lalue L — �d i►..1
D�SI�P.CIO]1'/BCO�E OF AI�,WORK BEING DONE
. � � �-r `�-.-�� � �
VA,LUE(lnr�pd�g labor end�a�erisls)$ /� •�
�LEG�'ATCgI,CDNTRACTOR(for projects nnt requfr�an EIY Form) s� +
��. �f �`�C L� G
07/D? �
. May. 9 2013 4: 18PM GMS INC No, 5027 P. 2
a , _ ..
n ����
� ����
�:a..�e�.....
POB�c��Do
� O�h WI l/903-I13o
oBee rlans.saw
Fuc StZ1,276.s06r
Elect,ric xnstallation Verification
i�,�,e� SLIM'S ELECTRIC INC. � -
(Eloctrice!Co�nhactor l+�am�)
2608 Qakwood Circle Oshkosh WI 54904
(Addr�as) (CitY) (Steae) (Zip Codo)
hsve bee�cantracted to perfonm olechie iostallenon.�ovorlc for ��-�J l �'
(Namo of party con od to)
as the following address:
(AdQ�ss wbdre woric will be per,fo�ae�
The nature of tha wo�c consisis oF (Check pne or Desen'be tlne Nature of Work)
� Rocomnoction aa�n�w cucuit for replacamen�Headng Plant aad/or A/C CondGOSCr.
Recomnxtion or aaw arc�rit for ropiacement Ei�ctric Wa#er Heet�r or pvv�►er ve�ted
wacer hea�et.
Reeomoecrion o�f t�e Seivice�atraace Cable„Mda�Box,alt�rations tv c�cep�cles
aad lightiag fixtur�s due to siding/soffit iastellatiop. Note: Naa►Savice
En�ance Cables will�qalre a sepa:ate parmiz.
Reoonnection or�aew circui!frnr tbe roplaceme�i of othar p�maneatly wired
epp�9 I Cuct�res.
_w___ New circaft fior tihe adQitfoa otA�C w aa�»dlvf�rral dwelling urrrt(bouse or the
• mdividual systems ta a dupkx or condomini�m),�ch�ding roquired sarrioe
elec�ical ousleu.
OLhcr
The value of this vvork is� ��.�
1 hereby vorify this wa�k will be pafornuod by an e�nployee of tbis company aad fiuther verit'y
ths rocouneetion/ittistsllation will be donc ia comp4�with manufaccuzrr�d Elatric cod�
reqaircm�nta.
' ��q/9ve,o,�9 0�� �y�� l(.3 :
(Signawte of Cowp ces) (Print N�me.Qf Offi (I)ata)
s�ox
_ ...— – ------ �_. _� � . ._ _. . — _ �
`
,,