HomeMy WebLinkAbout0098974-HVACOSHKOSH
ON THE WATER
Job Address
Contractor
Fuel
System
Chimney Type
Heat Loss
BTU Rate
Use/Nature
of Work
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
No
2460 HEARTHSTONE DR
MCM AIR INC
~ Gas
[] New
Forced Air
Electric
Chimney A
O As Approved
~i~ As Per Plan
~_J Radiant
~ Hot Water
~,~ Chimney B
~ Existing
~ Variable
NSFR/ Install 60m btu furnace & 30m btu NC,
Owner MICHAEL/MARGIE PUHL
Category 502- Residential-Both
[] Electric
[] Replace
L-~ Steam
[] Suppl.
Solar
NC
Con. Burner
Direct Vent O Not Applicable I
~ Not Applicable I Value
~.~ Other I Value
Create Date
Plan
[] Other
98974
11/07/2002
Vent
Fees: Valuation
Issued By:
$5,400.00 Plan Approval
$0.00 Permit Fee Paid
[] Permit Voided I
· $86.00
Date 12/06/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number
(920) 582-4402
Eity of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 2Z6-f0~0
Fax (920) 236-5084
RECEIVED"
DEC 0 6 2002
DEPARTMENT OF '
, ,$ MUNITY DEVELO?MENT
HVAC PERMIT APPLICATION
All information aRcr bold categories nmst be provided.
Incomplete applications will not be processed.
ON THE WATER
· Application(s) and fcc(s) can be brought to City Hall, Room 205 or mailed to Inspcction Services, PO Box 1128,
Oshkosh W1 54903-1128. Commencing work without l~mit(s) will result in fees being doubled or $100.00 plus thc
normal permit fcc, which ever is greater.
If you are a contractor varticivatin~r in the'Permi[ fee Account System and haVe adeoUate funds, check here
if You want this processed throu~rh your account
CONTRACTO:R ~C~ ~ZR ~ Z~C
6122 COUNTY RD M WINNECONNE, WI 54986
582-4402 FAx 582-0136
Cm~.CK [] ALL APPLICABL~
USE CATEGORY
~lSingle Family
r'lI~plex OMulti-Family I'lRental r'lCommcxcial ~Industrial
FUEL ~oas E]Electric r=lSolid SYSTEM J~New fiReplace
I-Iq)il osolar OOther
TYPE
~Forced Air ORadiant OSteam l~lA/C '0Vent OElectric OHot Water I'ISupPl. I-ICon. Burner
IS ~Y BEING !JNED ~No I-lYes - LINER SIZE. ·
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACFURER
CHTMNEY TYPE
HEAT LOSS
BTU RATE
OChimney A
I~iAs Approved
~ Per Plan
OChimney B
r'lExisting
OVariablc
· ODir~t Vent
ONot Applicable
OOther Value
mOther
DESCI~I'EON OF ALL WO~'( BEING DONE
VALUE 0ndudin[ labor and a~ materials including Ught fixtures) $ ~ '/~ (~ 0
[3 For applicable projects, an Electric Installation Verification form, signed by the El~cal Contractor, must bc
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02