HomeMy WebLinkAbout0111075-HVAC (furnace & a/c)OSHKOSH
ON THE WATER
.lob Address 237 W 15TH AVE
Contractor PREMIUM AIR INC
Fuel [~J Gas ~ ~J Oil
System
New ~
Forced Air
Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner EDWARD/ANDREA SCHNEIDER
Category 501 - Residential-Air Conditioning
Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
111075
10/13/2004
Other J
Vent J
Use/Nature
of Work
furnace and A/C, line chimney.
Fees: Valuation
Issued By:
$9,965.00
Plan Approval
$0.00
Permit Fee Paid
Permit Voided J
$155.00
Date 10/13/2004
Parcel Id # 0902000000
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 N3225 HWY 15 HORTONVILLE WI 54944 -0 Telephone Number
920-982-3323
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 of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshko~sh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECE]VED
SEP 3 0 2004
DEPARTMENT OF
ELECTRICAL
All information after bold categories must be provided.
Incomplete applications will not be processed.
a Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed throufth your account []
JOB ADDRESS
OWNER ~-d
CONTRACTOR
DATE
CHECK ~ ALL APPLICABLE
USE CATEGORY
~qingle Family FIDuplex VIMulti-Family
SERVICE FINew F1Temporary
[]Change rqNot Applicable
rqRental F1Commercial Fllndustrial
TYPE []Overhead [Not Applicable
[]:]Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK ~ ALL APPLICABLE
[]Range F1Dishwasher
V1Fan OR Blower V1Fumace
I-IMotors FIGas Pumps
DEscRIPTION OF ALL WORK BEING DONE
[Garbage Disposal F1Dryer
~g~dC VIElectric Sign
r'lOther
F1WaterHeater
VALUE (Including labor and all materials including light fixtures) $ c~ ,E) d)
MASTER ELECTRICIAN T')/'~ ~ ~"IeM/ /