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OSHKOSH
ON THE WATER
Job Address 1105 GREENFI ELD TRL
CITY OF OSHKOSH
No
125801
HVAC PERMIT - APPLICATION AND RECORD
Owner JACK E RADTKE
Create Date 07/05/2007
Contractor WESLEY HEATING & COOLING INC
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type K:) Chimney A () Chimney B
Heat Loss K:) As Approved . Existing
BTU Rate l) As Per Plan () Variable
Category 501 - Residential-Air Conditioning
Plan
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
U Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
C) Not Applicable
() Not Applicable
. Other
Value
Value
Use/Nature SFR / REPLACE EXISTING CENTRAL AIR UNIT, EIV SIGNED BY KOLLMAN-REILLEY ELECTRIC
of Work
Fees: Valuation
$3,564.00
()/n( /C)
Plan Approval
$0.00
Permit Fee Paid
$64.00
Issued By:
Date 07/16/2007
o Permit Voided I
Parcelld # 1314450000
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
3220 BASLER LN
OSHKOSH
WI 54901 - 0
Telephone Number 920-235-6951
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
~
OfHKOfH
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, p.o Box 1128,
.oshkosh WI 54903,-1128. Commencing work without permit(s) will result infeesbeing doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor particioatinf! in the Permit fee Account Svstem and have adequate funds. check here
if VOll want this orocessed throuf!h vour account n .
DATE~n-Q'l
-
JOB ADDRESS \ \~~ CJ..~"1l. ~~~~ \~
OWNER~~~."~~ .
CONTRACTOR \....""),~"~\'.\~ ~j;)b~ *" C\~~.~,
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CHECK 0 ALL APPLICABLE
/l35 ~ (,tj'5/
USE CATEGORY
~ingle Family DDuplex DMulti-Family DRental DCommercial Dlndustrial
FUEL ~as DElectric DSolid SYSTEM DNew lJ(Replace
D.oil DSolar D.other
TYPE
DForced Air DRadiant DSteam ~A/C DVent DElectric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
DChimney B
~xisting
DVariable
~Direct Vent D.other
DNot Applicable
DitOther Value
DESCRIPTIO.N OF A~L WORK BEING DONE----~~ '- ~ \.:. ~
\:J-~~\:.)., ~ U ll'\: ~ Q
V ALUE'IncIuding labor and materh ;) $~\9..Li.. . ~
\
~ ~
ELECTRICAL CONTRACTOR
o For applicable projects, an Electric Installation Verification form, d by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
k~oo
10/04
07/02/20ea 22:16
9202737965
K-R ELECTRIC LLC
TO: 19202"73fS65
Ill!. Ii 1,#f
PAGE 01/02
P.4
I. l? I
-1~2e07 00= 12 fROM:WESLEY HEATIt>G ." (920) 235-6951
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Eleetrie Installation vertf.katlon
I (We) .~)~~..~~..~~",,,",,,.~ ~
(EIectritaI Contractor ~
\\~"'t UL~~ ~~"!l..,~.J~hlr~~ \ ~.
(Adchus) (City) (State)
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(Zip Code)
b&.vebeeu contnctted tOperbulel~ instaUation work for L"j~~~~_~'~ .
(Nweo'~) 'J
at thO toUowblgaddrcts; . \ \~Q e~~~1ta 1'-\ ~
(Address'VlJlte worlcwi1J be perlbnned)
Tbe natliIe ofthewmk comistJ of (CIaeck One or Describclhe Natl1tD ofWmt)
-.1.. RCCOlUlccnon or new clxnuit for repllament Heating Plaut lIddIor Ale. Coodenscr.
___ ~= or il~ ~t for ,..lat:e:tnent Eleetric W.er B.eaterot' p4Wa' \rented
water herder;.
__ Rec6nnection of the Service Entrance Cable. Meter Bml:t alterations tn ~JGS
and lighting :fixtures due to siding I soBit IrmaUation. Note: New- Senice
Entmnc6 Cables will require a sepaI3te permit.
_ Reconnection or new circuit (or the rqJlecement ofo1her~'wimI
appliattCe$ { fixtures.
_ New circuit for the addition of AI{; to an i.1fdWidwl dtvellinglmu {JJouse or the
individual systems in I duplex or condominium}. indudiD&required semee
el~l outlets..
_ Other
~.oL"""
TIle value of this llV'O-rt.: IS $ t ']:}~
-'
I hereby verify thi. worlc win be performed :. y an employee of this company and further veri.fy
the reeoMection ! instaUatkm will ~done ia compliance with manntacturer:and atechic cede
requirements.
. \
j~1!~_. ~.
?(Sigmtfure of Company Offit<<)
'10,.,-
~ Jere~~ L?L--
{Prin(NameofOfficerl
7-;2 '07
.
(Date)
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