HomeMy WebLinkAbout0104728-HVAC (water heater)OSHKOSH
ON THE WATER
.lob Address 1255 W 18TH AVE
Contractor
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
GARTMAN MECHANICAL SERVICES
Oil
Owner VILLA ST THERESA INC
Category 510 - Ind. & C0mm-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
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
104728
10/10/2003
Other J
Vent J
Use/Nature COMM/Replace hot water heat. *EIV form from GMS Inc.
of Work
Fees: Valuation
Issued By:
$6,500.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$102.50
Date 10/10/2003
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.
City nf Oshkosh
P.O. ilia 1130
Oshkash. WI 54003-1130
Pimnc (920) 236-5050
Fax (920) 236-5084
o ^l)plioalion(s) and
nm-mai pormil fcc, whioh over !.
OR
/f
JO
FllEI, ~Oaa VIl~icolrio
il ElSoler
TYPE
CIFm'ccd Air ElRadianl VLql~aiO
ils CHIMNEY BEING LIIqED I
Fir)to: All cldmnoys shall bo SiZed per
CHIMNEY TYPE
ilEAT LOSS
BTU RATE I-IAq
DESCRIPTION OF ALL ~
V~ LUE (lnclpdl~il labor and #il ar
For applioablc praj¢O~8~ m
aUaohed.
Elee,t. ric Installation Verificati'o!l
I (We) ,3a~_ tmaa Macaanzca~
(Electrical Contractor Name)
~20 .W'.
(Address) (City) (State)
have been contracted to p~rform electric installation work for vi 11 a S t. Th e'r'e S a:
(Name of
at the following addrcss: 1255 W. 18th 0shkosh~ WI 54902
(Address where work will be performed)
The nature of thc work consi~:ofi (Cheek One or Describe the Nature of Work)
X
Rcconneetion or new circuit for repleeomcnt Heating
Rcconneetion or
water heater
Reeonncct~on of the Serw~ Entrance Cable, Meter Box, alteratiom to receptacles
and lighting ~xtures due to siding / soffit inst~l, ation. Notc: New Scrvicc
Emrance Cab]es wi}l require a separate pv,,uit. . ' ' .
Reeonneetion or hew c~rcuit for the replacement of other permanently wired
appliances / fixture~.
New circuit for the addition of A/C to an individual dwdling unit (hpllse~ or ~.e
individual systems in a duplex or condominium), including reqU!re~d Sel'vm~
electrical ou~l
Other
The value of this work is $. 100. O0
I hereby verify this work will ,be performed by an e.m. ployce.ofthis company and ~fiffther verify
· e reconncction / installation ~vill be done in compliance w~th manufacturer and El~ .eqtri~c 'erode
requirements.
(Signature'of ~o~y Officer)
(Prim Name of Officer)
11/8/03