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OSHKOSH
ON THE WATER
Job Address 1171 PARK RIDGE AVE
CITY OF OSHKOSH
HV AC PERMIT - APPLICATION AND RECORD
No
127971
Owner CL YDEIALBERTA NEUENFELDT
Create Date 11128/2007
Contractor
CONDON TOTAL COMFORT
Category 500 - Re~!den!~Cl~:Hea..t!!!g~\I_~!1!iLa..tit:l9.___
Plan
BTU Rate
l!:J Gas -~ [JOII---J ITEIeCtilC--l D Sola!~~:=~J
o New 0 R~EI~__~~
~ Forced Air ] U Radiant:=J U Ste~~~~~===:::=J
~ctrlC-l ~Waterl USuppl=--_~ U Con:J:[l!0~~]
O_f!:lJm~____D~b~~:~=:=~~ct~enr=-===.- Not AppliS:~~I~_-~~J
Q3s Approved C) Existing .licJtAPPITCab~=-===] Value
[IAs Per Plan ~ Variable_ . Other---~===~] Value
D SolicL~==-::
D_9l~Elr___----l
o Vent --::]
Fuel
System
Chimney Type
Heat Loss
Use/Nature ISFR 1 REPLACE GAS FURNACE, EIV SIGNED BY HEATLEY ELECTRIC '.check 18379
of Work I
I
I
I
i
I_._-~...._---.~------'-~--'
______~_____~Q,goo
-"----------------------1
Fees: Valuation $1,590.00
Issued By: ~s-:--------
Plan Approval
$0.00
Permit Fee Paid
$34.00
- _..._,-----.__._,--,~
Date 11/28/2007
Pt3_r~i~\I?icl~J
Parcelld # 1222550000
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 184
RIPON
WI 54971 -184 Telephone Number 920-748-5050
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HV AC 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, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If yOU are a contractor partiCivatinf! in the Permit fee Account System and have adequate funds. check here
if you want this vrocessed throuf!h your account n
** Advisory - For applicable projects, an EleCtrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE
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JOBADDRESS \ \1\ 'PArK R;d~e. A\!e
OWNER (hide. '-tA \ De.r-t:.o.-- . . le.-uer'Lf-e.-\o\t
CONTRACTO~ eof'dOrL rOTA L wn"Farl. IN Q.
CHECK 0' ALL APPLICABLE
ppE CATEGORY
~Single Family DDuplex DMulti-Family
DRental
DCommercial
Dlndustrial
FUEL
~Gas
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
~Replace
TYPE
rziForced Air DRadiant DSteam DAlC DVent o Electric DRot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED tz:iNo DYes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE DChirnney A DChirnney B DDirect Vent DOther
HEAT LOSS DAs Approved o Existing DNot Applicable
BTU RATE DAs Per Plan DVariable lR10ther Value Lola ,ODD Btu\L
DESCRIPTION / SCOPE OF ALL WORK BEING DONE lQ..X\'(\O'L 90 Sfun'lAce
07/07
Nov-28-07 07:19A HEATLEY ELECTRI~
N Q 'I. '/. 1. :L I) l) , 1 : U ~ ~'M J n 5 0 e ct Ion s er '11 c e s
9207487900
N'J. 6301
P~02
P. 3
City orOlIlk"s/l
Divisio~ oflll.l'pceDoD Sc:vil;.l
215 Chord! AW_
1'0 I\.)lC 1130
O$h~ah WI S4903-1130
Otlia 92Q.23~'O'O
Fall Il~O-]J6.SlJ&4
I (We)
Electric lnstallation Veritication
HEATLEY ELECTRIC
611 N 5T ANTON
RIPON. WI 54971
(Electrical ConlractorName or Homeowner's Name)
I-A! - fe" r R: (,f9tIfJ~ -
(Address) (City)
.
(State)
(Zip Code)
accept the responsibility to perfonn the eleclric wcrk as stated below, at the following address:
(( -, (
f A If ((' K ( tJ6 t:. A V(-
(Address where work witlbe performed)
The nattlre of the work consists of: (Check One or Describe the Nature of Work)
./ Reconnection or llew circuit for replacement Heating Plant and/or NC Condenser.
Reconnection or new circuit for replacement Electric. Water Heater or power vented
water heater.
Reconnc:ctio.a of me Service Entrance Cable. Meier Rox~ alterations to receptacles
and lighting fixtures due to siding I ~Of.fil installation. Note: New Service
Entrance Cables will require a separate pennit.
ReConT\eCllOn. or new circuit for the replacement of other permanently wired
appliances I fixtures.
New circuit for Lhe addition ofAlC to an individual dwellingunil, including
required service electrical outlets. Nott: Homeowners can emIy do their own
electric on a singlefamily owner occupied home. Worle 011 a condominiuln,
duplex, rental, or mllfri-use b1~ildil'lg would require a licensed Electrical
Contr(lctor.
Other
The vatue of this work is $ ~'7)
-tf:gy.
"I'"
( JU "--
I hereby verify this work 'Nillbe performed in com.pliance with the License requirements of
Section 11-22 of the Oshkosh Municipal code and further verify the: reconncctio.a / installation
.~.ill e done}n pliance. with manufacturer and Electric code requirements.
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