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109889
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
KIRK D/SHIRLEY ROSE
Job AddressOwner
1405 E NEVADA AVE
Create Date08/09/2004
ContractorFOX VALLEY STONE & BRICKCategory503 - STOVES AND FIREPLACESPlan
OilElectric
üü GasSolarSolid
Fuel
üü NewReplaceOther
System
Forced Air üü RadiantSteamA/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue
Use/Nature
SFR/ Installation of new gas fireplace, and construction of structure to enclose new fireplace.
of Work
Plan Approval$0.00
Fees: Valuation$6,523.70Permit Fee Paid$104.00
Issued By:Date08/09/2004
Permit Voided
Parcel Id #1513200000
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
Address1405 E NEVADA AVEOSHKOSHTelephone Number
WI54901-3113
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.