HomeMy WebLinkAbout0120201 H
e
OSHKOSH
ON THE WATER
Job Address 1105 N MAIN ST
CITY OF OSHKOSH
No
120201
HVAC PERMIT - APPLICATION AND RECORD
Owner STANLEYG/KEREN L LANGE
Create Date 06/22/2006
Contractor PREMIUM AIR INC
Fuel U Gas UOil
System o New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type o Chimney A () Chimney B
Heat Loss () As Approved () Existing
BTU Rate () As Per Plan o Variable
Category 501 - Residential-Air Conditioning Plan
U Electric
D Replace
U Steam
U Suppl.
o Direct Vent
l
I
U Solar U Solid
D Other
~ AlC U Vent
U Con. Bumer
. Not Applicable
. Not Applicable
. Other
Use/Nature SFR / ADDING AlC UNIT EIV PROVIDED BY PREMIUM AIR INC-ONE HOUR
of Work
Value
Value
Fees: Valuation $3,674.00
Issued By: ~0
Plan Approval
$0.00
Permit Fee Paid
$60.50
Date 06/22/2006
D Permit Voided I
Parcel Id # 1007630000
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
5165 GREEN VALLEY RD
OSHKOSH
WI 54904 - 9794 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.
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~
OJHKOfH
ON THE WATER
City of Oshkosh
Division ofInspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
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Electric Installation Verification
I (We)
?(em\um ~(") L(\L-~ .
(Electrical Contractor Name)
have been contracted to perform electric installation work for
\/'-IT .'5fOtoLJ-_
(State) (Zip Code)
t<exe.n bH~'
(Name of party co tracted to)
at the following address: nO~ N. tv\Q~\f\ sA I Osh \{os~
(Address where work will be performed)
5( ~5 . bWL"\ Vn\\~ RA
(Address)
O-Sh Kos~
(City)
The nature ofthe work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or NC Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
....appliances / fixtures.
~--New circuit for the addition of NC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ ~.{)f:q
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
~~
(Signature of CompanyOfficer)
MJIO/(( t4fr
(Print Name of Officer)
& !19/o~
(Date)
5/02