HomeMy WebLinkAbout2002 -HVAC (furnace; a/c)OSHKOSH
ON THE WATER
.lob Address 732 W 4TH AVE
Contractor MCM AIR INC
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner KATHRYN L PROCKNOW
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
99083
12/13/2002
Other
Vent J
Use/Nature SFR/Install 60m btu furnace & 18m btu A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$4,500.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$72.50
Date 12/13/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number
(920) 582-4402
City of Oshkosh
Division oflmpection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
DEC 1 5 2002
Incomplete a~B~fiom ~ ~t ~ ~
ON THE WATIH~
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed ~ Inspection Service% 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.
Olt
If you are a contractor partic(vatin~ in the'~ermii 'fee ,tccount System and have adeOuate funds, check hqrq
if you want thts_vrocessed through your account
OWNER
CON~C~ORMCM AIR~ INC 6122 COUNTY RD M
582-4402 FAX
WINNECONNE, WI 54986
582-0136
CHECK [] AL1. A~?LICABL~
m CATEGORY
gl¢ Family
ODuplex r'lMulti-Family
~Rental
r'lElectric ElSolid SYSTEM ONew
OSolar glOther
~Industrial
ed Air [3Radiant OSteam C ClVent OElc~ric
is CmM~¥ BEING U~D ONo ~Yes - Ln~ ST~ · 5 ~
Note: AIl chimneys shall be sized per the BTU's being vented. ' r
CIHotWater EISuppl. EICon. Burner
CHIMNEY TYPE
HEAT LOSS
BTU RATE
OCh/mn~ A
OAs Approved
OA~ Per Plan
rlChimnc~ B
OExisting
OVariablc
ODire~t Vent
~Not Applicable
OOther
DESCRIFHON OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ /'~0 oo
ELECI~ CAL CONTRACTOR ~'} ~-(.~-- ... '
,~For ~pplicable project% ~n Ele¢~ic Instalhtion Verification form, .igned by thc El~cal Con~ctor, mu~ b~
attached. If not attached Or not applicable, a separate Electrical Pet-llt is rexluired.
9/02
Electric instmlhtiou Verification
(.,Lct~s) (a~ (s~f~) (z~ cock)
hAvolmm conb~ to perform ebo~c ~nwo~ For
New ~ for r~o sddbio~ ofA/~ m m f~W&m/d~d/lt~ ~# (house or ~e
b24~yiduil rym~ in m ct~l~ o: ~mn), b~udin~ reqGJ.-Kl sen4ce
ebob'Lo&l oGtlm.
TIM viluo ~t,~,.~s wc~ ii S
I hmby v~/thb work w~l be porf'om~ by ~n employee ~tbis ccm3t~ny mhd ~ veri~
O~nt ~ of C~,or) 0:)~)