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OSHKOSH
ON THE WATER
Job Address 2447 BLAKE CT
CITY OF OSHKOSH
No 123367
HVAC PERMIT - APPLICATION AND RECORD
Owner GARY G/SARAH J TROXELL
Create Date 01/29/2007
Contractor THOMPSON HEATING AND COOLING S
Fuel 0Ga5 ~ U Oil
System Q Ne~__
0FQrced Air U Radiant
DElElCti;~ U Hot Water
Chimney Type ~imney A o Chimney B
Heat Loss o As Approved C) Existing
BTU Rate (If.s Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
D Replace
U Steam
U Suppl.
o Direct Vent
U Solid
U Solar
[lAIC
U_.f.s>n. Burner
. Not Applicable
~ Other
LJ Vent
. Not Applicable
. Other
Use/Nature CONDO / HEAT RETURN RUNS TO BASEMENT REMODEL
of Work
Value
Value
Issued By:
~L:J
Plan Approval
$0.00
Permit Fee Paid;.
$25.00
Date 01/31/2007
Fees: Valuation
D Permit Voided I
Parcelld # 0622050100
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Osh~9sl::l-/1as no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this Remiit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and t~~~~~ecessa~ appro s fore starting such activity. .' /--.
Signature 4/~ Date ~~ 7
Address
901 OTTER
OSHKOSH
WI 54901 - 0
Telephone Number 920-426-3095
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
(f)
OfHKOfH
.ON THE WATER
HVAC PERMIT APPLICATION
All infonnation 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
Ify.ou are a contractor Darticipatinf! in the Permit fee Account System and have adeouate funds. check here
ifvou want this Drocessed throuf!h your account n .
JOB ADDRESS Z </17
~&~~ ~
DATE
//s/~/7
. OWNER
CONTRACTOR '1l~~ ~~//V(",,/
CHECK Ia ALL APPLICABLE
USE CATEGORY
~Single Family ODuplex OMulti-Family
DRental
o Commercial
Ofudustrial '
FUEL
~Gas
DOil
DElectric DSolid
o Solar
SYSTEM
DNew
pOther
DReplace
TYPE
~orced Air DRadiant DSteam DAlC DVent o Electric OHot Water OSuppl. DCon. Burner
IS CHIMNEY BEING LINED ~No DYes. - LINER SIZE & MANUFACTIJRER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChimney A DChimney B DDirect Vent DOther
HEAT LOSS DAs Approved DExisting DNot Applicable
BTU RATE DAs Per Plan DVariable DOther Value
DESCRI. PTIO. N.OF ALL WO)U{BElNGDONE /h~4~/ k=nA~ f2UJ-/5 --It,
. 1)/Kt:=:fl1/7 <'--"7'--+ t:-&"'7-n 0 7) 6~
VALUE ~
ELECTRICAL CONTRACTOR ;11~
o For applicable projects, an EI~ctric Installation Verification form, signed by the Electrical Contractor, must be
attached. Ifnot attached or not applicable, a separate Electrical Permit is required.
$ <~;:rrt., /7,
,
\000, t)(j
9/02