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CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
CREATIVE CUSTOM HOMES & DEVELOP INC
Job AddressOwner
3201 BELLFIELD DR
Create Date07/23/2003
ContractorMARTENS HEATING & COOLINGCategory500 - Residential-Heating & VentilatingPlan
OilElectric
üü GasSolarSolid
Fuel
üü NewReplaceOther
System
üü Forced AirRadiantSteamA/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue
Use/Nature
NSFR/ 2 story home with a 2 car attached garage. Heating system for new home.
of Work
Plan Approval$0.00
Fees: Valuation$3,680.00Permit Fee Paid$60.50
Issued By:Date01/14/2004
Permit Voided
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.
SignatureDate
Agent/Owner
AddressPO BOX 106WAUKAUTelephone Number920-685-0111
WI54980-106
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.
Cady of Oshkosh
Division of Inspection Services
P.O, Box 11,30
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084 ...,. -.p.m...,
RE c
HVAC PERMIT APPLICATION .. .
....
All information after hold categories must he provided. JAN -1 r, c„ :
Incomplete applications will not he processed.
4 e , ' I ",;‘' , 0 " v iri c ap' linj i l l 3 t .. 15 1 13 1 1g , the
7j JArr oc
:7 ;L
• Application(s) and fee(s) an be brought to City Hall, Room 205 or mailed ,
Oshkosh WI 54903-1128, Commencing work without permit(s) will testa, . , ' i .
normal permit fee, which ever is greater.
OR .
if v,Pu_are a contras 1 1 i012_a tble in th2§.1.1411,14cAs co nnt, Systiin and have adequate funds, cheet here
if you want this pro4!essell_thrmat .12,ypuzsiledvaLITI
JOB A.DDRESS i &.] Ifio id_ r
OWNER.C.CW._:_b..Ve„
CONTRACTOR_Mallcias_flealinj_t_CD_Diiii t .
CHECK lil ALL APPLICABLE
USE' , TEGORY
11 «Ingle Family ODuplex 0Multi-Family EIRental 0Commereial Olndustrial
FUEL t cldas OElectric ['Solid SYSTEM
r °Replace
EJOil °Solar
TYP
arced Air °Radiant .13Steam, OA/C [Went °Electric 011ot Water OSuppl.E1Con. Burner
IS CHIMNEY BEING LINE Yes -, LINER SIZE _ _ & MANUFACTURER
DP ' c) D
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE Ogaimney A °Chimney B °Direct Vent °Other
HEAT LOSS ."°•• As Approved ElExisting °Not Applicable
STET RATE L.E;1‹,,li Per Plan OVariable °Other Vette
, 60 o
DESCRIPTI( N OF ALL WORK BEING DO.Q1_, , __. , _ (
6, / SD) ,
. ,
f ,
VALUE (Including labor and all materials including light fixtures) $ 36SDi eo
ELECTRICAL CONTRACTORA/041,1 , . _._ „92 0 Electric TrAmtigtion VertntatiorA form littilChed(if Replacement)
Electrical installation of new/replacelnenz equipmenl shall be thane by licensed contrite
2/