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o
OSHKOSH
ON THE WATER
Job Address 3166 QUAIL RUN DR
CITY OF OSHKOSH
No
123791
HVAC PERMIT - APPLICATION AND RECORD
Owner SINGH, KASHMIR & RES HAM
Create Date 11/20/2006
Contractor EXTREME HEATING AND COOLING INC
Fuel ~ Gas UOil
System ~ New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type o Chimney A () Chimney B
Heat Loss K.) As Approved C) Existing
BTU Rate IC) As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
D Other
~ AlC LJ Vent
U Con. Burner
. Not Applicable
U Electric
D Replace
U Steam
U Suppl.
e) Direct Vent
. Not Applicable
. Other
Use/Nature NSFR /INSTALL NEW HVAC SYSTEM FOR NEW HOME **check #3583
of Work i
Value
Value
Fees: Valuation $10,059.00
Issued By: ~W
Plan Approval
$0.00
Permit Fee Paid
$161.00
Date 03/14/2007
D Permit Voided I
Parcelld # 0660290300
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
AgenUOwner
Address
1754 FREEDOM RD
LITTLE CHUTE
WI 54140-0
Telephone Number 920-687-2332 920-6
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 of Inspection Services
P.O. Box. 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
MAR 0 6 2001
~
OJHKOfH
ON THE WATFR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and feees) 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
nonnal permit fee, which ever is greater.
OR
Ifvou are a contractor varticipatinf! in the Permit fee Account System and have adequate funds. check here
if you want this r:;rocessed throuflh your account n
OWNER CL
CONTRACTORk. 1-+ f' If /fit?
DATE (J-5.- cJ 7
~
-----
:lIJC
CHECK ItJ ALL APPLICABLE
USE CATEGORY
~Single Family. o Duplex DMulti-Family
DRental
o Commercial
DIndustrial
FUEL
~s
DOi!
DElectric OSolid
DSolar
SYSTEM
lSiN"ew
DOther
OReplace
TYPE
pporced Air ORadiant DSteam DAlC DVent OElectric OHotWater DSuppl. Deon. Burner
IS CHlMNEY BEING LINED DNo DYes - L1f..mR SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CIDMNEY TYPE
BEAT LOSS
BTU RATE
DChimney A
DAs Approved
OAs Per Plan
DChimney B
o Existing
o Variable
DDirect Vent DOther
ONot Applicable
OOther Value
DET~~ AIL W;~;EJN~:~~1 ;t ~ ~ . rq "5'
A a.J-A " .. I ~~ ." ( "" f . Yf J'- It .
!J 1" J4'-i .~ /:J
)
VALUE (lrlduding labor and all materials including light fixtures) $ / ,,/ C;l$' ~ t1 0
ELECTRICAL CONTRACfOR
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. Ifnot attached or not applicable, a separate Electrical Permit is required.
9/02