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HomeMy WebLinkAbout0098832-HVAC CITY OF OSHKOSH HVAC PERMIT -APPLICATION AND RECORD OSHKOSH ON THE WATER Job Address Contractor Category 502- Residential-Both Fuel b~J Gas I L~ Oil [ ~J Electric I L~ Solar system [] New I [] Replace I L~J Forced Air j [~ Radiant I [_~ Steam I ~J NC I ~ Electdc I [~ Hot Water I U Suppl. I ~ Con. Bumer I Chimney Type ~ Chimney A (.~ Chimney B (_~ Direct Vent ~1 Not Applicable I Heat Loss ~.~ As Approved ~ Existing ~t Not Applicable I Value BTU Rate ~.~ As Per Plan ~ Variable ~I Other I Value 836 DELAWARE ST MCM AIR INC Owner DEL TRI3-r No 98832 Create Date 10/31/2002 Plan ~-Solid [] Other Vent Use/Natureof Work NSFPJ Install 60m btu furnace, 1.5 T/18m btu NC, and ductwork. FeeS: Valuation $4,600.00 Plan Approval $0.00 Permit Fee Paid Issued By: [] Permit Voided J $74.00 Date 11/27/2002 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Address 6122 COUNTY ROAD M Agent/Owner WINNECONNE WI 54986 -9780 Telephone Number (920) 582-4402 ON THE WATER Application(s) -nd fee(s) c~m be brought to City Hall, R~iji~l~~Services, PO Box 1128, Oshkosh Wl 54903-1128. Commencing work without l~'riiiJ(s) will result in fees berg doubled or $100:00 plus the normal permit fee, which ever is greater. If_you arc ~t contractor varticipatin~_ in the'Permi{ fee ,4ccount System and have'adeauate funds, check here if you want this.processed through your account JOB ADDRESS ~$:7~ (/~ D~ U ~ ~/x3~ ~E., ~'~ DATE CONTRACTOR MCM AIR, INC 6122 COUNTY RD M WINNECONNE, WI 54986 582-4402 FAX 582-0136 CI:~,CK [] ALL APPLICABLE :: .';.: ,~..::./.., ~-. ::',.::. ~. -... ~Single Family .E]Duplex E]Mulfi,Family [2Rental - FUEL ,~JaS DElectric I-ISOlid SYSTEM I"lOil l-lSolar I-IComm~'cial .~]Industrial ed Air ORadiant I-ISteam DVent Fl£1eotric IS CI~MNEY BEING IJNED ~No I-lYes - LINER SIZE · Note: All chimneys shall be s/zed per the BTU'$ being vented. DHot Water CISuppl. I-lC. on. Burner & MANUFA~ CHIMNEY TYPE OChinmcy A I-I~nmcy B . ODircct Vent [~l(Other ~5 q C. tIEAT LOSS I-lAs Approved I-IExisting DNot Applicable BTU RATE D-lAs Per Plan ClVariable I-lather Value DESCRIFFION OF ALL WORK BEING DONE Q~IE~ 5%i~tT~O/DO-~ /c<3,0oo ~-3TO ~U~i,~oF~ v ~d.V..O0t~ loST I~,0oo IS,TO /'q/C o~ DOc.Tu00~W---- ~ALUE (Including labor and all materials including light fixture) $ ~'~ (~ OO o,~ .... ::'~ ~:~ '::: ELEcTRICAL'CoNTRACTOR ...... 6U lU~'[~, S ~ U~C,T {~-~(-* ' ~ ~ · ,' [] For applicable projeCts,' an Electric Installation Verification form, signed by the EleCtrical Conlxactor, must be attached. If not attached or not applicable, a separate Electrical P~-mit is required.