HomeMy WebLinkAbout0114574-HVAC (a/c)
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OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
114574
HVAC PERMIT - APPLICATION AND RECORD
Job Address 855 FREEDOM AVE
Owner
MICHAEL J/JOLEN HOSTAK
Create Date 06/10/2005
Contractor MCM AIR INC
1 1 Gas 1 1 Oil
Fuel
1,(1 New 1
System
U Forced Air U Radiant
1 1 Electric 1 1 Hot Water
Chimney Type () Chimney A 0 Chimney B
Heat Loss 10 As Approved 0 Existing
BTU Rate 10 As Per Plan 0 Variable
Category 501 - Residential-Air Conditioning
Plan
1,(1 Electric
1 1 Replace
1
1 1 Other
1 U Vent
1
1 1 Solar
1 1 Solid
U Steam
1 1 Suppl.
l..j A/C
1 1 Con. Burner
0 Direct Vent
. Not Applicable
. Not Applicable
. Other
Value
0
Value
2T
Use/Nature SFR/ Install A/C - EIV provided by Seckar Elect
of Work
Fees: Valuation
$1,700.00
Plan Approval
$0.00
Permit Fee Paid
$30.50
Issued By:
Date 06/10/2005
U Permit Voided 1
Parcelld # 1250173700
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
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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.
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Electric InstallatioD VeriflcatioD
l(We)..:.~~ el£c.:r~" Go. 11Je.
(Electrical CoatrlCtDrNamo)
S~r1J¡} rmJeY PUJ¡\1~~~ ~b. ~/tJ~~~JJt.le:(~~~~exø
have 'œen contracted to perform electric imta1la1io1l wo:k 1'or ~.
(Name otpany eon\nÇ\e4 to)
It the 1'oUowing address: ~ S S ç IZ. E:: E: 00 H A \j t. .
(~ where work will b, poribancd)
The nature o!the workCOl1SÏlts of: (ÇbeçkOllcorDescribetheN&tIIrcof'Wock)
-- Reoonnection or now cf.rçuit for roplacement Hea%hI¡ P1a:at &rJ4Ior AlC CcmcIome:r.
-- R.ccomlection or now cirçuit for rep1lccment mectrlo Water Heater or power vented
. water beater.
-- R.cccmncçtjon of tho Sc:Mcc &tranco Cable, Meter Box. alterations to receptaCles
and lighting fixtureI due to IidiII¡ IlOmt inat,I].tlQI1. Note: New Scrvic:o
Bntraœe Cables will require a aeparato permit.
-- Recom1ection or now ciI'I:uit for the rq:I1acemcnt of'otbcrpermancntly wired
appl!aÐcœ / fixt\lrel.
-r'tS.. New circuit for the addition of AIC to aD illåivlduD/ dwtIlllnz lUlU (house or the
in4ivið\Wl)'ItemJ In a duplex or ~11111), Including required service
electrical outlets. .
-- Other
Tho value o!thia work ia sJ f)o. 0 0
I hereby verifY thiJ we&' will. be performed by aD employee otmla company and t\1rtber verify
tbc l'CCQtI:1octiOl1/ instaIlation will be done in COIllpUance with manu!açturer cd Electrlc code
roqujre_. .
j~~ f1{L
(Si¡nannlof Compmy Officer)
þ/,wg 'I!.. 5el):.1J¿
(Print Name of' Officer)
b-5-o6
(Date)
510:
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