HomeMy WebLinkAbout0101801-HVAC (rooftop unit)OSHKOSH
ON THE WATER
,Job Address 36 E 10TH 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 EVERETT IND BLDG CO
Category 500- Residential-Heating & Ventilating
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
101801
05/28/2003
Other J
Vent J
Use/Nature
of Work
Replace rooftop unit. *EIV form from Witzke Electric.
Fees: Valuation
Issued By:
$5,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$93.50
Date 05/28/2003
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 of Oshkosh
Division of Inspection Services
P.O. Bax 1130
Osi,kosh, W! 54903-1130
Plmne (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be'provided.
Incomplete applications will not bo processed.
Q/1-K.O/H
ON TIlE WAIEll
· Application(s) and fee(s) can be brought to Cit~ Itall, Room 205 or mailed lo InsPection Solrvioes, P.O Box 1128,
O,;hkosh WI 54903-1128. Commencing work without permit(s) will i'esul! in fees being doubled or $100.00 plus
normal permit fee, which ever is greater.
OR
If ro~.~ a_.r_e_a c_o_anD'actor particip..qt.i_ang in the Per;ni_~_fe_q Accou!H R..l'~'tem and ha_v~ adeq,ate_fttnds, cheg~ Itere
~ ~,ou want thi~' processed thro~!tgh_vour account
CUECK [] ALL APPLICABLE
USE CATEGORY
I-3E ingle Family
FIDuplex l-3Multi-Family IZlRental ['-J Commercial l~ttndustrial
U1Eiectric ElSolid SYSTEM IZINew
IEISolar I-IOther
TYPE
[3Forced Air I-IRadiant E]Ste,~m I-IA/C EVent IZlEleetrio
IS C.][IIMNEY BEING LINED DNa L-lYes - LIN'ER SIZE
i'Iole: All chimneys shall be sized per 0:,' BTIJ's being vented.
Fl!lot Water EISuppl. EICon. Burner
?',,- MANIJFA~R -
CHIMNEY TYPE 12]Chimney A I-IChimney B ElDirect Vent. I-lO/her
III.?.AT LOSS f-lAs Approved []Existing 12]Not App~icabio
~lTll RATE I-lAs Per P!?n i-IVariable IZIOther Vohm
DESCRIPTION OF ALL WORK BEING DO C~ ~ ,3'[~
.LI.~E (Including labor ami ali materials Including light fixtures) $~ -' 7L~/~ .... ---, ,,w
ECTRICAL CONTRACTOR
[] For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor0 must be
attached, fl'not attached or not applicable, a separate Electrical Permit-is required.
-' MA9.19.2~3 ?:4BAM WITZKE ELECTRIC. N0.586 P.27~
Electric Installation Verification
~lec~cal Contractor Name)
155 E. Argue.., D osa
(Ad~es: whe~ work will b~ pe~o~ed)
Th~ nature of~e work con~is~ of: (Ch~k One or Desc~be ~e Na~e of Work)
~ Keco~e~fion or n~ c~t for ~lacem~t Hea~g Pl~t
~ K~co~eofion or n~ circ~t for r~lacement alec~ Water H~s~ or power v~ted
wa~er heat~,
~eco~ec~on of~e So.ice ~n~cc Cable, Met~ Box, alt~ations
~d ~ ~x~es due ~o si~ / soffi~ ~st~Ia~on. No:~; N~
~n~c~ Cables wi~ mq~: a sep~at~ pe~i~.
heco~oc~on or new circuit for ~c r~plac~en~ ofom~ p~fly wired
appli~c~ /
N~ ~ircuit,for ae ~on of MC to ~ i~i~[ ~llt~
~vidu~ syst~s in a duplex or condomini~), ~clu~nt req~red ~i~e
0~er
(Zip Code)
Thc value offs work is $_.~.~d)~, aD
I hereby verify this work wilt be pc'formed by aa cmploy~e oft. his comply and further w-ify
the reconnect/cfi / installation will be done in compliaace with manufacturer and Electric cods
requirements,
(Signaur~ of Con:l~any Office0
('Print Name of Officer)
(Da~a)