HomeMy WebLinkAbout0102180-HVAC (furnace)OSHKOSH'
ON THE ,WATER
,lob Address 1815 DOEMEL ST
Contractor MCM AIR lNG
Fuel I¢'J Gas I
System [] New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Forced Air
Electric
Owner FREDERICK R LUCK
Category 500- Residential-Heating & Ventilating
t..I oil I [] Electric 1 [d Solar
J [] Replace
U Radiant U Steam U ~C
J ~con. Burner
0 Not Applicable
[] HotWater 1 I I Suppl.
ChimneyType ~) ChimneyA ~ Chimney B ~) DirectVent
Heat Loss ~..) As Approved O Existing
BTU Rate ~ } Aa Per Plan ~ Variable
Not Applicable i Value
Other I Value
No 102180
Create Date 06/13/2003
Plan
[] So,d
[] Other
Vent
Use/Nature ;FR/Install 60m btu furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$3,000.00 Plan Approval
$0.00 Permit Fee Paid
[] PermitVoided J
$50.00
Date 06/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construcUon.
Signature Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number (920) 582-4402
City of'Oshkosh ·
Division ~f Inspection Scrvices ~
Phone (920) 23~5050 ~ ~~
HVAC PERMIT PLIcATIo U '
~O~le~ a~om ~ not ~~
PO
Box
1128,
Os~o~ ~ 54903-1128; Coercing wink ~out ~t(s) ~1 ~t m~~f~s ~~or $100,~ pl~
noel ~t fee, w~ch ev~ is ~t~,
If you are a contractor DarticioattnE tn the ~ermit fee ~ccount System and have adeauate fund& check hqr~
if you want tht~ ~rocessed through your account ~
CONTRACTOR MCM AIR, INC.
CHECK [] ALl. APPLICABLE
DATE
6122 COUNTY 'RD M, WINNECONNE, WI 54986
582-4402 FAX 582,0136
USE CATEGORY
[~ingleFamily []Duplex
[Multi-Family I-IRcatal
I-ICommercial
FUEL ESGas [3Electric [Solid
E]Oil E]Solar
SYSTgM I~N~v ~"place
mOther
TYPE
l~Forced Air r'lRadiant r'lStcam r'IMC ClVent ClEleclxic
IS cmrIVINEY BEING LINED ClNo El.Yes - LIYtER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
I-IHot Water CISuppl. I'lCon. Burner
CIilMNEY TYPE ClCliimney A 13Chimney B ClDir~t Veat
HEAT LOSS I-lAs Approved J~'Existing · []Not Applicable
BTU RATE I-lAs Per Plan [~?~ariable I-tother Value
VALUE (Including labor and all materials including light fixtures) $ ~ 00 0, 0 0
:l~,For applicable projects, an Elec~c Installation Verification form, signed by the Elec~¢al Conm~xor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
Electric Tnsti~htion Verification
(S~nax~ o/Company On.r)O~ofOn~r) ~)