HomeMy WebLinkAbout0098676-HVAC (furnace)OSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
1341 WESTERN ST
MCM AIR INC
[~j Gas I bd Oil
[] New I
[~J Forced Air I L~ Radiant
~ Electric I b~ Hot Water
~ Chimney A ¢.~ Chimney B
~ As Approved ~11 Existing
~.~ As Per Plan ~I Variable
Owner TIMOTHY R KRAUSE
Category 500- Residential-Heating & Ventilating
bd Electric I bJ Solar
[] Replace I
L-~ steam I b-J NC
~ Suppl. I M Con. Burner
Direct Vent ~I Not Applicable I
(...~ Not Applicable I
() Other I
. Value
Value
No
98676
Create Date 11/18/2002
Plan
I LI Solid I
[] Other
Vent
Use/Nature
of Work
SFR/Install 80m btu furnace. *EIV form from Seckar Electric.
Fees: Valuation $2,800.00 Plan Approval $0.00 Permit Fee Paid
Issued By:
[] Permit Voided I
$47.00
Date 11/18/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address
6122 COUNTY ROAD M
Agent/Owner ,
WINNECONNE WI 54986 -9780 Telephone Number
(920)582-4402
Division of~on ~.ces
P.O. Box 1130
Oshko~, WI 54903-i130
~'hon~ (920)
Fax (920) 236-50~4
:'::" ~'"'~ :;"2 ~::.; .' ' '" ' ' ' . ~ 7
RE'CEIVED( ).
· NOV 1 8 2002
I)EP^RT~ENT OF ~
HVAC PERMIT AP~~EVELOP[vIENT
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled er S100:00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor oartici~arin~ in the'J~ermii 'fee Account System and have'ade~zare funds, check
tf vou want this orocesSed through your account N
CO~~OR MCM AIR, INC 6122 COUNTy
582-4402
-RD' M WINNECONNE, WI 54986
FAX 582-0136
USE CATEGORY
,t~Sin~le F~i~,'':: :E]~I~
FUEL [~as O~cctric OSolid ~~ ONcw
OOil O3olar ClOthrr
TYPE
l~Forced Air . ORadiant OStcam OMC '0Vent C]Elcctric
IS CHIMNEY BEING I.INED 0~No OYes - LINER srzl::
Nora: All c~,i,--~s flmll b~ sized per the BTU's bcin~ vcntgd.
[~-IotWatcr OSuppl.
& MAN~A~
EICcm. Bum=
~ TYPE
m~T LOSS OAs Approved ~..xisting C]Not Applicable
BTU RATE OAs Pcr Plan I~Vsriable OOthcr Valu~
DESCRIFrloNoc,AI~ WO~BE~GDONE '~'. ~"~O. 11 0_..CI
OChimncy A ochi~ B on~.t v~t ~:r, her P V
b-k ~AV Po [~o
ELECTRICAL CONTRACTOR. ,~ 6. O_.k~ ~ ~ I ~. ~T-Y- ~ ~ ..
O For applicable pro. icom, .an £1cclric Installation Verification form, signed by th~ Elc~-trical Contractor, mu.~-bc
attachcd. If not attached or not applicable, a separate Electrical P~-,..it is rcquircd.
9/02
Electric Installation Verification
(Zip Co~e)
~ame of pray oon~actcd to)
(Ad~ss where woi ~11 be p~fo~)
of ~ work. c~is~ of: (C~k One or
R~eofion or new circuit for r~l~e~nl He~n~ P~t ~'or ~'C Con~s~.
~~on or n~ c~cuit for repl~em~t El~c Waler
~ec~tiou of ~c Sc~'icc ~ce Cable, Meter Box, alterations to re~p:a~les
~d 1i$~n8 fix~ ~c to sidiut /
~eco~ou ~ new c~cuiI for ~e r~lacem~t of other p~gy ~dr~d
NOW c~t f~ the ld~tion of MC to ~ i~ividual dwellt~g ~i~ (ho~ or the
in&vied systems in a duplex or condommi~),
Oth~
k' 'c t¢ co. ,
(Electrical Contractor ~c)
(~s'~) ' (Ci~ .... (State)
I hc~by v~ify l~s work will be p~omed by ~ ~ployee of~is campmy md ~her ~efify
~ ~omt~O~/ins~gation ~511 be done in co~ce wi~ m~facturer ~nd EI~c code
(Si~ure o~ Comply O~cer) (~nt Nm= of Offic=) (Date)