HomeMy WebLinkAbout2002-HVAC (add new a/c) OCITY �F OSHKOSH No 95657
i
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address �250 LIBERTY ST Owner JON SNICKIE�FREDERICKSON Create Date 07/05/2002
Contractor MCM AIR INC Category 501 -Residential-Air Conditioning Plan
Fuel ✓ Gas Oil Electric Solar Solid
System ❑ New __ _ � � Replace_ i �_Other .'�
✓ Forced Air Radiant � Steam ✓ A/C Vent
Electric Hot Water Suppl. Con. Burner
ChimneyType ChimneyA ChimneyB DirectVent NotApplicable ��
Heat Loss As Approved Existing Not Applicable Value 0
BTU Rate As Per Plan Variable Other Value
Use/Nature FR/Add new 38TKB018 1.5 ton 18,000 BTU A/C.'EIV from Seckar attached.
of Work
Fees: Valuation $'1,500.00 Plan Approval $0.00 Permit Fee Paid $27.50
Issued By: .�/ Date 07/OS/2002
Y
� Permit Voided '�.
In the performance of this work,I agree to pertorm all work pursuant to rules governing the described construction.
Signature Date
AgenVOwner
Address 6122COUNTYROADM WINNECONNE WI 54986 -9780 TelephoneNumber (920)582-4402
Ciry of O!�}ilcosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fa�c (920)236-5084 V I �
�� n
ON TNE WATER
HVAC PERMIT APPLICATION
All info:marion 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. Commrncing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
1 ou are a contractor artici atin in th rmit fee Account Svstem and have adequate funds check here
lvau wanr thu nrocessed throueh vour account , _
DATE � � - �`� �-�:Z_
JOB ADDRESS I L��U t 11✓C 1�� y
OWNER JGt�i �r ��i�� ti F�'-Ei�?�����:c:���-
CONTRACTOR_ MGN1 Al�i IN
6122 County Rd M �
CHECK �ALL APPLICABLE Winneconne, WI 54986
USE CATEGORY
�Single Family ODuplex ❑Multi-Family �Rental ❑Commercial ❑Industrial
FUEL J�as ❑Electric ❑Solid SYSTEM ONew ❑Replace
❑a>> oso�az ❑o��
TYPE
�Forced Air❑Radiant ❑Steam�/C ❑Vent OElectric ❑Hot Water�Suppl.❑Con. Bumer
IS CHIMNEY BEING LINED ❑No ❑Yes -LINER SIZE &MANCTFACC[JRER
Note:All chimneys shall be sized per the BT[J's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑D'uect Vrnt ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicabie
BTU RA'1'E ❑As Per Plan ❑Variable ❑Otha Value
IJe��
DESCRIPTION OF ALL WORK BEING DONE ��D ?��T k-�C� � z� 1 � `� � � �R s�j;��s E�� ��
�1 I �- TC� �X�l�I I I�? G I-t��I�-1 E
;� �
VAL[TE (Including Iabor and ail materials including light fixtures) $ � �-� ��C'
ELECTRICAL CONTRACI'OR���C-L�-(� �< ���KMe installation Veritita[foo form attac6edpfReplacertirnq
Ele nc (nsla(lation of new/replottmen(equipment rha!(6e done bylicensal mntmctors.
3/02
Jun D9 02 08: 48a Oahkosh lnapeecionn ��- --- •
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Eiectric Installation Verification
I(We) S� �Z� I G CD. IJG -
(F,lectrical Contracwr Namo)
,� COJ�TUr�1 P�Upv3+�2 RR W tN�EcodNE t,J� 6�986
(��� �(,yt�,) (State} (Zip Code}
�a�e beqi coatraetad to perfoxm electric installatiou work for /'"� A'/�
(Nnme of pazsy conuacted�o)
at t1►e fol►cwing eaaress: 1'Z''�0 'L 1 (3���`I
(Addresa where work will bo pacfoaned)
'The asAue of the work consiats of: (Cuxk One or Describe the Nature of�l%ork}
� Reooimeotlon or ew circuit r replacement Heating Plaat and�'or fv'C Condeaser.
Recoaeeotion or n wt for replacement Eleca�ic Water Iioater or power vented
Wi2pL�1EL[R.
Reconnation of the Sonice Esntrance Cable,Mater Sox,elterations w receptaeles
and lighting fixtures due to eidiy�1 eoffit inatallation. ATote: New Service
E�ce Cables will nquin s aeparate permit.
Aecof�aeetion or naw c'ucuit for the re�lacement of other permanently w�red
— appliaoces/fixturea.
New circuit for the addiaon oi A/C W an txdivlduQl dwalltng unit(house ur the
indiviCual eystams in a duplex or coadominium),including required service
eleotriael outlets.
� Other
The value oft�is work is S s'�° •
i hereby verify this work will be pafotmed by an employee of this campany and Punher verify
t�e reeon�.ioctiori/iaetaIlation will be done in complianee with r.�ann°acrurer a.�d Elecaic code
requiramente.
I�(�k3 I�°. S�K�2 '� -� -0 L
(Signature o Company Officer) (Print Name of Officer) (Dacc)
s�o�