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OSHKOSH
ON THE WATER
Job Address 1523 DOEMEL ST
CITY OF OSHKOSH
No
123331
HVAC PERMIT -APPLICATION AND RECORD
Owner DONALD REIMER
Create Date 01/26/2007
Contractor ACE CHIMNEY SERVICE
Fuel ~ Gas UOil
System D New
U Forced Air U Radiant
U Electric ~ Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss D As Approved () Existing
BTU Rate U As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
D Replace
U Steam
U Suppl.
. Direct Vent
U Solar I U Solid
o Other
U AlC U Vent
U Con. Burner
C) Not Applicable
. Not Applicable
. Other
Use/Nature SFR / RE-L1NE CHIMNEY FOR ORPHANED WATER HEATER
of Work
Value
Value
40,000
Fee" valuat~w
Issued By:
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 01/26/2007
D Permit Voided I
Parcelld # 1514120000
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 tosecure any neces ry approv Is before starting such activity.
Signature
Date /~~.t.. -- O?
Agent/Owner
Address
PO BOX 1946
OSHKOSH
WI 54903 - 1946 Telephone Number (920) 279-0197
---
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 ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OJHKOfH
ON THE WATER
HVAC 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If v'ou are a contractor participating in the Permit fee Account System and have adeouate funds. check here
if yOU want thisvrocessed through your account n . .
DATE /.-.;<6.- 07
DRental
DCommercial
DIndustrial '
FUEL
l2JGas
DOi!
DElectric OSolid
o Solar
SYSTEM
DNew
DOther
OReplace
TYPE
DForcedAir ORadiant OSteam ONC OVent OElectric ,8HotWater QSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNo ~y es - LINER SIZE ~ Y':? s- r & MANUFACTURER ;:-/~;c ~ II T'e-r 7t;"'ACt-f:~
Note: All chittmeys shall be sized perthe BTU's being vented.
CHIMNEY TYPE OChimney A dChirnney B DSlDirect Vent DOther
HEAT LOSS OAs Approved o Existing 69Not Applicable
BTURATE OAsPerPlan o Variable tiOtherValue T'fO.OOtd llTCA. ~
/
DESCRIPTION OF ALL/WORK. BEING, DONE ~ e (,'.... I'~ '" C t., ,'"" '" ~ V /0 .--
{;) /' .b L... a.. h ~ ~ \A./~-t-~- h _" -t~.-'I /' /
/ .
VALUE
.$ ~OC\O 0
ELECTRICAL CONTRACTOR
o For applicable projects, an Electric Installation Verification forin, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02