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e
OSHKOSH
ON THE WATER
Job Address 1360 MARICOPA DR
CITY OF OSHKOSH
No
123689
HVAC PERMIT - APPLICATION AND RECORD
Owner. ANDREW/DEIRDRE DEWITT
Create Date 03/06/2007
Contractor ZILLGES MATERIALS, INC.
Fuel l.!"J Gas UOil
System ~ New
U Forced Air U Radiant
LJ Electric U Hot Water
Chimney Type () Chimney A () Chimney B
Heat Loss () As Approved () Existing
BTU Rate () As Per Plan () Variable
Category 503 - STOVES AND FIREPLACES Plan
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
. Not Applicable
U Electric
o Replace
U Steam
USuppl.
C) Direct Vent
. Not Applicable
. Other
Value
Value
Use/Nature SFRllnstall a new direct vent gas fireplace.
of Work
Fees: Valuation
1,986.90
Plan Approval
$0.00
Permit Fee Paid
$40.00
Issued By:
Date 03/06/2007
o Permit Voided I
Parcelld # 1312430000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address 1800 FOUNTAIN AVE
OSHKOSH
WI 54904 - 0
Telephone Number (920) 231-1994
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
=-= 03/05/2007 09:55
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9202310017
ZILLGES MATERIALS Ie
PAGE 01
Pivision of Inap@ction Servi~es
215 Church Avenue
P-O. BoX 1130
Oshkosh, WI S~903-1130
Fax # (~20) 23~-SOS4
Phone (920) 23~-S04e
'* PI&-$t' rOLe.$!; P"1~i .(,-.ir/L /)Vr
/1-tl--OV"'+. '
HVAC PERMIT APPLICATION
All fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
3-r;--07
JOB ADDRESS /3.6' 0 fYl~("\ LOf6.-
OWNER tJy ~:ft=
CONTRACTOR z. ~ \ +: ; ref Io..c..e I. L L-
CIRCLE ALL APPLICABLE
USE CATEGORY ~~~ DUPLEX
FUEL @ OIL ELECTRIC
SYSTEM ~ REPLACE
c Ihy tlvesJ.;O<\~ '^-II t>1....K~ d3/-/'1'1'i)
MULTI-FAMILY
COMMERCIAL
INDUSTRIAL
SOLAR
SOLID
OTHER
TYPE
FORCED AIR
.~ CRAD~~"'I.I~~S1EAM
HOT WATER SUPPL.
AI C VENT
ELECTRIC
CON. BURNER
IS CHIMNEY BEING LJ:NED NO LINER SIZE
Note: Ali ch~mneys shall be sized per the BTU's
MANUFACTURER
..
being vented.
@REc!- VE-v
~i"A'PPLICAB-.fD
OTHER VALUE
OTHER
CHIMNEY TYPE
CHIMNEY A
CHIMNEY B
HEAT LOSS
AS APPROVED
EXISTING
BTU RATE
AS PER PLAN
~IABLE J
NATURE OF WORK: r,,~~\l 6.... ~.e w Q;....e~+. Ve.",t ~ ~.~ F~r'ofrl~{,.~
VALUE (Including labor and :materials) $ /qgb,' flO
r::.:r.:;:C'l'~.!C;.'\L CO~ITr.Z'...C'.:.'OR, ~"e r
Electrical insta11ationof new/replacement equipment shall be done by licensed
contractors.
Valuation
Fees
s 0 to $1, 0 0 0 . 0 0 ..--._...._..._._....__................_.........................._.......m_........__................_...._._ $ :2 0 .0 0
$1, 000.01 to $10,000. 0 0..___._._......__.__............_._...._.........._..................._.........._....__..$ 2 0 . 00 for .f irst
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$1 0,.. 0 00 . 01 t 0 $.2 5 , 000 I a.o........................_..........................,...."...........d"'....:...........n...'...........\...."..".IIo..n.....Mn$.~ $' 5, 00 if ~~ f.i arB t;
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Ove r $ 2 5 , 00 0 . 0 0 ............~__._.._._.._.___....__......._......._...._._............._.................................._.__$ 3 0 5 . 0 0 p 1 u s $ 0 . 5 0
per $100.00 valuation or part thereof
· Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
g:r:-eater. -