Date Project Address
HVAC Permit #
(Issued By City)
Owners Name Phone # ( )
Address City Zip
E-mail Address Tax Key #
Contractor 24 hr. Phone # ( )
Address City Zip
Project Description License #
Base Fee of $50.00 + (______sq/ft for all areas x .06 sq/ft) = ____________
Description Each Count Fee
Gas, oil, electric and coal furnace and boiler
One and two family First 150,000 BTU 35.00 ______ _______
Commercial First 150,000 BTU 45.00 ______ _______
All over 150,000 BTU $3/50,000 BTU ______ _______
Air Conditioning
One and two family 35.00 ______ _______
Commercial 45.00 ______ _______
All over 36,000 BTU $2/12,000 BTU ______ _______
35.00 ______ _______
1.25/KW ______ _______
______ _______
______ _______
Fireplace and wood burning stove
Electric baseboard, wall unit and cabinet unit
Fire Suppression Systems Restaurant Stoves, Fryers, Boilers
Duct work alteration
Other
HVAC Electric
15.00
35.00
______
25.00
______ _______
Minimum Permit, Reinspect or Failure to call for inspection $50.00 each
Double fees are due if work start
ed before permit is issued.
For inspections call the building inspector @ (262) 569-2195.
The applicant agrees to comply with the municipal ordinances and with the conditions of this permit, understands that the issuance of the permit creates no legal
liability, expresse or implied, of the Department, Municipality, Agency or Inspector, and certifies that all the above information is accurate. Have Permit/Application
number and address when requesting inspections.
Signature of Applicant_________________________________________ Date ____________________________
Print and sign permit, then mail or drop off along with permit fee (cash or check).
Permit will not be processed until all requirements are received.
V:\Building Inspection\HVAC Permits\HVAC Permit FF 6.8.20.pdf
Total Inspection Fee ___________________
New Building Addition & Remodeling
Replacement, Modifications or Individual Items
City of Oconomowoc
Department of Building Inspection
174 E Wisconsin Ave. Oconomowoc, WI 53066
www.oconomowoc-wi.gov 262.569.2195
Heating, Ventilation &
Air Conditioning
PERMIT APPLICATION
Permit Approval by Permitting Authority. Application is hereby approved and permit issued by the City of Oconomowoc subject to
full compliance by the Applicant with all conditions set forth by the Department of Public Works.
Check # : ____________________________ City Representative: _________________________________
Date: ______________________________ Date: _____________________________________________
From: ______________________________
Conditions of Approval: _____________________________________________________________________________________________________
Office Use
NO REFUNDS ON PERMIT FEES
Elec
trician
(Base Fee of $50.00 ) + (area x .06 is a min of $70.00)
= (a min. fee of $120.00)
Total = __________
(min. fee of $120.00)
License #
Phone #
______
______
Clear
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