HomeMy WebLinkAbout0101270-HVAC (a/c)OSHKOSH
ON THE WATER
,Job Address 929 EVANS ST
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GARTMAN MECHANICAL SERVICES
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner ARTHUR V JORDEE
Category 501 - Residential-Air Conditioning
Electric
Replace
Steam
Suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101270
05/05/2003
Other
Vent J
Use/Nature SFR/Replace a/c. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$1,450.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$27.50
Date 05/05/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address PO BOX2264 OSHKOSH WI 54903 -2264 Telephone Number
(920) 231-5530
City et'Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (020) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories mus! be provided.
Incomplete applications w. ill not bo preccssed.
Oyl-l(OfH
ON THE WATER
· Application(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
O,A~kosh WI 54903~1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
L[__~,271,_ are a contractor participating in the Per~nbt fee Account £~,stetn and have adaquate_fttnds, check h¢r,
i~,~2~ ,van, th.i, proc~.&sed throug.h. _your accoltnt ,~ 7 ql~ir>~O
.-, D,i~ALL APPLICABLE'~
CI-IE~ ,K
LISE JATEGORY
~p~ i n gle Family FIDuplex tDMulti-Family I-IRental ~Commercial
EIIndustrial
FUEl, ~;as VlElectric EISolid SYSTEM EINcw
il EiSolar [-'lOther
Repl~cc
TYPE ~put
12-1Forced Air EiRadiant V1Steam C VIVent V1Electric
IS C][IIMNEY BEING LINED EINo IDYes - LINER SIZE
Note: Ali chimneys sl~ali be sized per tile BTI, J's being vented.
IDIIot Water VISuppl. EICon. Burner
& MANUFACWURER
CIIlMNEY TYPE V1Chimney A [3Chimney B VIDirect Vent V1Other
tlEAT LOSS VIAs Approved VIExisting FINer Applicable
iITU RATE V1As Per Plar~ VIVariable IDOther Value __
DESCRIPTION OF ALL WORK BEING DO _ c~_ .
VAI. i:UE (includi"g labor and all mhter~als including light fixtures) $ .9 ~) '
ELF..CTRICAL CONTRACTOR ~__~
[] For applicable projects, an E!ectric lcgt~lation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or no~ applicaBIC', a separate Electrical Permit is required.
e/oa
- 04~29/2003 21:13 9282317255 BEEZ ELECTRIC PAGE 03
City of Oshkoeh
215 ~hu~h Av~
POBo~ 11~0
Oll~osh WI ~a90~.1130
Electric Installation Verification,
(I) (We) Beez.Electric~
521W. 12th. Oshkosh X~. 54902
have been contracted to perform electric instzllation work for C_mrtman Mechanic~,
at the following address: ~treet.
The nature of thc work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heatin~ Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Keconnection of the Service Entrance cable, Meter Box, alterations to receptacles and
lighting fixtur~ due to siding / soffit installation. Note: New Scrvice Emrance Cebles
will require a separate permit,
Reconnection or new circuit for othc~ permanently wired appliances / fixtures.
Other
Th~ value or,his work is $~
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installatiot~ will be done in compliance with manufacturer and Electric code
requirements.
(Signature of Company Officer)
04/,,30/03.