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115129
CITY OF OSHKOSH
No
OSHKOSHHVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
ROBERT G O SIMON/AMANDA J CARLS
Job AddressOwner
1765 CLIFFVIEW DR
Create Date07/11/2005
ContractorAIR TECH HEATING INCCategory501 - Residential-Air ConditioningPlan
OilElectric
üü GasSolarSolid
Fuel
New üü ReplaceOther
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
SFR/ Replace furnace, install 3" chimney liner - No EIV provided - A SEPARATE ELECTRICAL PERMIT IS REQUIRED FOR CONNECTION
of Work
OF THIS APPLIANCE.
Plan Approval$0.00
Fees: Valuation$2,750.00Permit Fee Paid$47.00
Issued By:Date07/11/2005
Permit Voided
Parcel Id #1524720500
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
Address1305A INDUSTRIAL PKWYFOND DU LACTelephone Number920-924-6742
WI54937-0
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.