HomeMy WebLinkAbout0103458-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 48 MILL ST
Contractor MCM AIR INC
Fuel ~ Gas
System ~ New
~ Forced Air
~ Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Owner ELLEN A DUEX
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Radiant
Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A ~) Chimney B ~ Direct Vent O Not Applicable I
Heat Loss I~ As Approved ~ Existing O Not Applicable I Value
BTU Rate I~ As Per Plan ~) Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
103458
08/12/2003
Other
Vent J
Use/Nature SFR/Replace furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$3,700.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$60.50
Date 08/12/2003
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 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number
(920) 582-4402
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 ~fO~sh
Division oflml~cfion Scrviccs ~'~ ~
'
P~ne (920) ~&5050 ~ ~] ~ ~
F~ (920) ~&50~ ~ / . ~ ~~
HVAC PERMIT '
~o~I~ a~E~om ~H not ~ ~ h~f~ / D~
· A~lioa6~(s) md t~(s) ~ ~ ~u~t m Ci~ Hall, R~m 205 ~ ~~, ~ Box 1128,
Os~o~ ~ 54903-1128.. ~o~g w~k ~out ~i.~s) ~ m~t ~ f~ ~g do~led ~ $1~.~ plm
n~l ~t f~, w~ch ~ is ~t~.
OR
ff vou are a contracwr oartt~lvatln~ tn tAe ~ermit fee decount Swtem and ~a~e adeauate funds. ~h¢¢k
ff vou want tM~ ~roce~ed tArou~A your aeeou~t ~
JOB ADDRESS [ E/~(.; tv -
DATE
o-T'
6122 County Rd I~1
I.:H s:CK [] ALL APPLICABLE Winneconne, WI 54986
~ .... ~ :~Eie~d ElsOiid SYSTEM
ElOil QSolar
TYPE
EIForced Air V1Radiant ElSteam [3A/C F1Vant I'lElectric
E]Hot Water [~Suppl. FICon. Burner
& MANUFAc'rORER H,'q'J~>/-°' EC~O L~ y
CHIMIVEY TYPE
HEAT LOSS
BTU RATE
[2Chimney A
ClAs Approved
EIAs Per Plan
ElChirnney B
[2Existing .
DVariable
ElDirect Vent
r'lNot Applicable
DESCRIPTION OF ~1.1. WORK BEING DONE ,-,~ J~ ~ J~'O ~>O
VALUE (Including labor nnd all nmterlalsinduding Ught flxtm~)$ : ~O0 oa
ELECTRICAL CONTRACTOR 5~]Lf~a , , .":.~ ;,,'.
:;'(- .~For apPlicable projects an Electric Installation Verification form, signed by the F_Aect~cal ConWactor,
/a~hed. If not a~tached or not applicable, a separate Electrical Pcamit is required. ·
must be
9/02
Electric Y,,;t~dhtiou Verlflc~on
=~.) (~r..~. E'/..e'ct-~b- Co.