HomeMy WebLinkAbout0112949-HVAC (furnace & a/c)
112949
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
ROGER A/KAREN A NOVOTNY
Job AddressOwner
2401 MINERVA ST
Create Date03/08/2005
ContractorPREMIUM AIR INCCategory502 - Residential-BothPlan
OilElectric
üü GasSolarSolid
Fuel
New üü ReplaceOther
System
üü Forced AirRadiantSteam üü A/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue
Use/Nature
SFR/ Replace furnace and A/C EIV provided by Premium Air - NO CHIMNEY LINER BEING INSTALLED -Where an appliance is permanently
of Work
disconnected from an existing chimney or vent (C/V), the C/V shall be resized as necessary to control flue gas condensation in the interior of the
C/V and to provide the appliance or appliances served with the req. draft.
Plan Approval$0.00
Fees: Valuation$5,465.00Permit Fee Paid$87.50
Issued By:Date03/08/2005
Permit Voided
Parcel Id #1229440000
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
AddressN3225 HWY 15HORTONVILLETelephone Number920-982-3323
WI54944-0
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
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 O f _HKO ( _
ON THE WAT R
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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 adeyuate_funds, check here
if you want this processed through your account ❑
DATE _P-4 —p S
JOB ADDRESS A 40 / A1,`nr r vrx
OWNER f�,pt e ;. rep-) ijovofny
CONTRACTOR ?rprni,.t,ri /4tr /h/ Lnn� ' w.
CHECK 0 ALL APPLICABLE
USE CATEGORY
rziS in Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK I?1 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower Furnace ZA /C DElectric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ U)/ 4 - iv r) &&I f 5 g,p0
MASTER ELECTRICIAN 1 -t `.,A rye Pt-i• 1 nC., 4 . 44)1i a ' 1
3/02