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OSHKOSH
ON THE WATER
Job Address "1138 EVANS ST ~
Contractor WESLEY HEATING ~OLlNG INC
CITY OF OSHKOSH
No
116551
HVAC PERMIT - APPLICATION AND RECORD
Owner
MARJORIE A BOLDING
Create Date 09/29/2005
Category 500 - Residential-Heating & Ventilating
Plan
1 1 Solar
I 1 Solid
Fuel
1,(1 Gas
7] New
1 I Oil
1
1 I Electric
n Replace
n Other
System
U AlC I
I I Con. Burner 1
() Not Applicable
U Vent
U Forced Air
I I Electric
U Radiant
1,(1 HotWater
U Stearn
1 I Suppl.
Chimney Type () Chimney A
Heat Loss
( ) As Approved
K ) As Per Plan
() Chimney B
. Existing
. DirectVent
BTU Rate
( ) Variable
( ) Not Applicable
. Other
Value
Value 85000
Use/Nature FR/ Replace existing furnace with new boiler - No Chimney Liner bein9 installed - EIV provided by Solar Elect.
of Work
Fees: Valuation
$8,633.00
Plan Approval
$0.00
Permit Fee Paid
$135.50
Issued By:
Date 09/29/2005
D Permit Voided I
Parcelld # 1110250000
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 tI1e work
described in this permit application within an easement, the City stron91y 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
N8804 N DOUGLAS ST
RIPON
WI 54971-0
Telephone Number
920-748-6494
To schedule inspections please cali 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.
e
OSHKOSH
ON THE WATER
Job Address ~ 1138 EVANS ST
CITY OF OSHKOSH
No
116551
HVAC PERMIT - APPLICATION AND RECORD
Owner
MARJORIE A BOLDING
Create Date 09/29/2005
Plan
Contractor BREWER HEATING
Fuel I"'¡ Gas
System Iï'I New
U Forced Air
I I Electric
Chimney Type () Chimney A
Heat Loss ( ) As Approved
BTU Rate K ) As Per Plan
Category 500 - Residential-Heating & Ventilating
I 1 Oil
1
n Other
1 1 Electric
n Replace
U Steam
I 1 Suppl.
I 1 Solid
1 1 Solar
U Radiant
I"'¡ HotWater
( ) Chimney B
. Direct Vent
U AlC 1
I 1 Con. Burner I
( ) Not Applicable
U Vent
. Existing
( ) Variable
( ) Not Applicable
. Other
Value
Value 85000
Use/Nature FR/ Replace existing furnace witl1 new boiler - No Chimney Liner being installed EIV provided by Solar Elect.
of Work
Fees: Valuation
$8,633.00
Plan Approval
$0.00
Permit Fee Paid
$135.50
Issued By:
Date 09/29/2005
D Permit Voided I
Parcelld # 1110250000
In the performance of this work, I agree to perform all work pursuant to ruies governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such actvity.
Signature
Date
Address
N8804 N DOUGLAS ST
Agent/OWner
RIPON
WI 54971-0
Telephone Number
920-748-6494
To schedule inspections please cali the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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Electric Installation Verification
I (We)
~\.~--... ~ \..,~..~ J
(Electrical Contractor Name)
~41J.,,~ ~ ~v..~ ~\
(Addms&)
C)..,~~
(City)
'\~
(State)
~t.\~
(Zip ~
ha,V,"" ~~eC!l:~,." utl'1lCte<!~pcrl'orm electric installation work for' ~" .. ~~,..~ ~~ .
, (Name. 0 ~
at the Cotlowing address: \ \ ~ ? "- ~ ~,
(Addres$ where WOIk will he perfom!ed)
The nature oCme work consists of. (Check One or Describe the Nature of Work)
..b... Reconnection or new circuit for replacement Heating Plant l1JJ.dJor NC Condenser.
- Reconnection or new eirclÚt for replacement JSleçmc Water Heater or power veufed
water heater.
- Reconnection of the Service Entnmce Cable, Meter Box, aJteratÎons to reccptac:Jc.
and lighting fixtures due to siding I soffit iD!ltallation. Note: New Senice
En~e c:.ble$ will require a sepatl!e permit.
- Rcconneclion or new circuit for the replacement of other permanently wired
appliances I fixtures.
- New cin:uit for the addition of NC to an individual dwelling Wlit (bow;e or,the
individnai systems in a duplex or CO1IdoIninium), including required service
electrical outlets. "
Other
The value of this work is $
/~
I hereby verify this work will be performed by an employee of this company and further mify
the reconnection I installation win be done in compliance with manufacturer and Electric code
requirements,
6?,'1~' 11 ~t elt~
(print a:o¡e of Officer)
q I ó2f /6'5
(Date)
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