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OSHKOSH
ON THE WATER
Job Address 1406 SOUTHLAND AVE
CITY OF OSHKOSH
No
125360
HVAC PERMIT -APPLICATION AND RECORD
Owner HAROLD W/MARIE WIRCH
Create Date 06/15/2007
Category 502 - Residential-Both
I Electric
o Replace
U Steam
U Suppl.
() Direct Vent
Plan
Contractor RYF HEATING & AlC INC
Fuel L"'r Gas UOil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type ~) Chimney A () Chimney B
Heat Loss D As Approved () Existing
BTU Rate () As Per Plan . Variable
U Solar U Solid
D Other
~ AlC U Vent
U Con. Burner
. Not Applicable
. Not Applicable
() Other
Value
Value
Use/Nature SFR I Replace furnace & ale. EIV provided by Seckar Electric.
of Work
$7,840.00
~
Plan Approval
$0.00
Permit Fee Paid
$128.50
Fees: Valuation
Issued By:
Date 06/15/2007
D Permit Voided I
Parcelld # 1609830000
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
PO BOX 450
WINNECONNE
WI 54986 -450 Telephone Number 920-582-4451
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
Fa..x (920) 236-5084
~
OfHKOfH
ON n-tF. \VATER
HVAC PERMIT APPLICATION
All infomlation 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. Cqrnmencing work without pemlit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
[fvou are a contractor participating in the Permit fee Account System and have adequate funds. check here
if yOU want this processed throuf7h your account n
i
JOB ADDRESS / '-10 {;, ~ oua.H-l I CL-'-t-~ A V G..
OWNER /-k/o/& W~rv4
CONTRACTOR Rtf P 1+~+-"'lA~ ~ 1I:.c. Tf..{ G
DATE ~ -{~ 0 7
CHECK 621 ALL APPLICABL~
USE CATEGORY
p(Single Family ODuplex OMulti-Family
o Rental
OCommercial
Olndustrial
FUEL
mtras
DOil
OElectric OSolid
OSolar.
SYSTEM
ONew
o Other
~eplace
TYPE
;RlForced Air ORadiant OSteam ~C o Vent o Electric OHot Water OSuppl. DCon. Burner
IS CHIMNEY BEING LINED JnNo OYes - LINER SIZE
Note: All chimneys shall be sized per the BIU's being vented.
I
& MANUFACTURER
CHIMNEY TYPE
HEA T LOSS
BTU RATE
OChimney A
OAs Approved
OAs Per Plan
OChimney B
OExisting
~Variable
ODirect Vent OOther
19Not Applicable
OOther Value
DESCRIPTIONOFALLWO I BEINGDONE Rz::r(:c,-r::;.. F4/~a.L_L rJ- ~
I
VALUE (lndo,"u. labor aud m.lrio")$ 715 'f <>. 0 .:J
ELECTRICAL CONTRACTO~ SC-Gk ~ /'
U For applicable proj ects, I an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached br not applicable, a separate Electrical Permit is required.
10/04
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ctI7 .fOt~
DMaioIl 01"- SaMOI>
US 0uId "..-
PO" UlO L_
CWIIMIIWJ _.1130
Om- ..a)~
PIX 'IWIWmu
I Electric Installation Veriftc:atioD
i
l(We) 6Ecf:J:. EL-ezne\c CO. l(\f~
I (Electrical Contractor Name) "
$Y1 20 Cf) VertJ~fLV/V1rra- €I? W ItJ 1JcLONNe
(AddreU) . (City) (State)
I
nave 'oeon comractcd ~o pl!ll'form electric installation work fo:
I
{;J J 5\fj~ ta
(Zip Code)
at me followins address:
el(~ HefrflfIJb
(Name ofpany eonttacted to)
/ e:; o' ~ 5o~ ~ / CL-<c fL /f-h",6-
(Address where work win be performc<l)
The natUre of the work eonsist$ of: (Check One or Describe the l'ature of \\. ork)
#
-
'Reconn.ction or new circuit for replacement Heating Plant andJor Ale Condenser.
Rocomteclion or M'N oircuit for replacement Blectric Wate:: Heater or power vented
w_~--r.
Roconnecnor. of the Service Entrance Cable. Meter Box. alterations to receptacles
and lighting fixtures due to siding IlOffit installation. Note: N ~ Servic.e
Eatnmce Cables will require a separate permit.
Ilecom1ccUon or new cireuit fur the replacement of other permanently wired
appUaDces I fixt\l1'eS.
~ew circuit for the addition of Ale to an IndividUfJI dwelllJtg UlfU (house or the
individual systems in a duplex or condominium), me1uding required service
e1eotrioal o\U1ets.
Other
The value ofti'll' world. S /7'5: 0 0 .
I hereby verify tbiI work will be performed by an employee of this company and further verify
the rcCcm:1OCtion I i11ltallation '\1ltill be done in compliance with manufacturer a.'1d Electric code
l'OCIuiromoutJ.
-D IfDJE s e-ctlrt:-
(print Name of Officer)
~/ -/~-07
(Date)
SIO~
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