HomeMy WebLinkAbout0104487-HVAC (furnace) SHKOSH
ON THE WATER
.lob Address 1933 MICHIGAN ST
Contractor GARTMAN MECHANICAL SERVICES
Fuel
System
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Gas J ~J Oil
New J
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner DEREKA SELL
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
104487
09/30/2003
Other
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Slim's Electric.
of Work
Fees: Valuation
Issued By:
$1,985.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$35.00
Date 09/30/2003
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 BOX2264 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.
'..i ~It nfOsbkosh
Osl~ko.i~, WI 54903-1130
Plmnc (920) 236-5050
Fax (920) 23~-5084
O~hkosh WI 54003-1
n¢,rmal permit fee. whioh t
OR
If rot~
JOB ADDRESS
CIIEt?IC 1~ ALL APPLICABLE
~/[/~E CATEGOliY
ingio Family
oPE
IS CllIMN~Y BEING LINED
CIiIMNEY TYPE DChi~cy'A
wru RAT~ ~A~ pc~ Pla.
V A LIJE (lacludla~ Iobor ami ali
I-IRolar
13 For applioablo
ailach&d, ifao~
Electric Instailatioa Verification
~ (we)
SLtM'S ELECTRIC INC.
(FJecUical Contractor Name)
2608 Oakwood Circle Oshkosh
(Addr~s) .... (C~)
WI 54904
(Sta~c) (Zip Code)
have bom contracted to l~ff~ .~rm cl~chic installation work for Gar I-man Maahan~ aa] .
(Namo of party contracted to)
at the following address:
1933 Michi!an
(Addre~ whcrc work will .be :~'formed)
The nature of the work cons~ts of: (Check One or D~c~ibe the Nsturc of Work)
X, Reconneclinn or n~vv circuit for replacement H~tin~ Plant and/or A/C Condenser.
Rvc, onncction or ~ ~ for r~l~mt El~c Wa~ Hm~ ~ ~ v~
w~ heat~.
R~on of~e Se~ ~n~ce C~I~ M~ ~x, ~s ~ ~t~l~
~d li~g fix~ duc ~ ~; ~ffit ~on, N~c: N~ S~
En~ce Cabl~ ~ll ~m~ a ~e
. , R~on ~ new c~t for ~e ~l~t of oih~ p~fly ~
~pH~ces ] flx~.
N~ c~c~t ~ ~ ~gon of ~C lo ~ tnd~ld~l ~llt~ ~t (~ or ~e
ele~c~
O~
Thc value ofthis work is $_ 150.00 .
I hereby verify this work will be performed by an cmploycc of this company and further verify
the reconnection / installation will be done in compli~ce with m~ruf~Uger and Eleclric code
(Print Name of Offic.~/) (Date)