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113810
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
SHANE T/SHANNON POLAKOWSKI
Job AddressOwner
1290 PHEASANT CREEK DR
Create Date05/03/2005
ContractorCONDON TOTAL COMFORTCategory501 - Residential-Air ConditioningPlan
Oil üü Electric
GasSolarSolid
Fuel
üü NewReplaceOther
System
Forced AirRadiantSteam üü A/CVent
ElectricHot WaterSuppl.Con. Burner
Chimney TypeChimney AChimney BDirect VentNot Applicable
Heat LossAs ApprovedExistingNot ApplicableValue0
As Per PlanVariableOther
BTU RateValue2.5T
Use/Nature
SFR/ Install new A/C system - No EIV provided - A SEPARATE ELECTRICAL PERMIT IS REQUIRED FOR CONNECTION OF THIS
of Work
APPLIANCE.
Plan Approval$0.00
Fees: Valuation$1,355.00Permit Fee Paid$26.00
Issued By:Date05/03/2005
Permit Voided
Parcel Id #1342503200
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 184RIPONTelephone Number920-748-5050
WI54971-184
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.