HomeMy WebLinkAbout0101562-HVAC (a/c)OSHKOSH
ON THE WATER
,Job Address 136 W 22ND AVE
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 MARGARET A MORTENSON
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
101562
05/16/2003
Other J
Vent J
Use/Nature SFR/Install A/C. *EIV form from Beez Electric.
of Work
Fees: Valuation
Issued By:
$1,500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$27.50
Date 05/16/2003
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
RECEIVED
City of Oshkosh
Division o£ Inspection Services
P.O. Box 1130
Oshko.sh, WI 54903-1130
Phone {920) 236-5050
Fa'{ (920) 236-5084
PlAY 1 6 2003
DEPARTMENT OF
CON~MUNITY DEVELOPMENT
HVAC PERMIT APPLICATION
All information after bold categories must be'provided.
Incomplete applications will not bo processed.
ON THE WATER
· Application(s) and fee(s) can be brought to Cit~ Itall, Room 205 or mailed to Inspocfion Servi.oos, p.o Box ! 128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will/'esult in fees being doubled or $100.00 plus tho
normal permit fee, which ever is greater.
OR
~._a,'e a contractor oartlc(natine In the Permdt .fee Account__~_}S .stem and have adeauate_funds, chect here
i.f_j~o~u ~v.a.!~.t /bi, processed thr[~ugh _~our account
OWNER
CliEt ?K ~?IALL APPLICABLE
¢5E .AXEGORY
[~ingle Family I--IDuplex [DMulti-Family [3Rental []Commercial Ullndustrial
FUEL ~Gas U1Electrie UlSolid SYSTEM w I-IReplooo
ElOil nSolar [3Other
YPE \
Forced Air [3Radiant IDSteam ~C EIVent ElElectrio
'x
IS CIIIMNEY BEING LINED [3,x-re Fl-yes - LIFTER SIZE
lqc~e: All chimneys shall be sized per the BTU's being vented.
Elliot Water [ISuppL
& MAIqIIFA~R
EICon. Burner
CIIIMNEY TYPE CIChimney A [3Chimney B IDDireot Vent
II-EAT LOSS i"iAs Approved t-lExisting [3Not Applies.bio
~ITU RATE f-lAs Per Plan ElVariablo f"iOther Value __
-.- &
DESCRIPTION OF ALL WORK BEING DONrlg
FIOther
VA ILIJE (lncludi,~g labor and all materials including light fixtures) $ '\ ,~-~,~\
EI,ECTRICAL CONTRACTOR~~-~.
~ For applicable projects, an E!ec~io ~sta~tion Ve~fication fem,. si~ed by thc Eleo~oal Con,actor, must bo
attached. If not attached or not applicable, a separate Eieclricai Pe~it ia required.
9/02
~ 05/i4/2003 00:3S S2023i7255 BEEZ ELECTRIC PAGE
Ci~ ~f
Di~io~ o~ In~ ~
Electric Installation Verification
(1) (We) B. eez Electric, I~c,
52.1 W. 12th Os~ WI 54909.
have been contracted to perform electric installation work for Gartman.Mechanical. S.~MCeS,
at the following address: I36 W__.J2nd St..
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.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lightixtg fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require a separate permit.
l~cconnection or new circuit for other permanently wired appliances / fixtures.
Other
The value of this work is $15.0,00
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.
(Signatm'e of Company Officer)
05114/03