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0 CITY OF OSHKOSH No 123959
OSHKOSH HV AC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3865 SHOREBIRD CT Owner FOX CITIES CONSTRUCTION CORP Cr eate Date 01/09/2007
Contractor MCM AIR INC Category 502 - Residential-Both PI, n
Fuel ~ Gas I U Oil I U Electric I U Solar I U Solid I
System [?J New I o Replace I 0 ::>ther I
l!J Forced Air I U Radiant I U Steam I l!J NC I U Vent I
U Electric I U Hot Water I U Suppl. I U Con. Burner I
Chimney Type U Chimney A o Chimney B . Direct Vent C) Not Applicable I
Heat Loss KJ As Approved C) Existing . Not Applicable I Value
BTU Rate KJ As Per Plan C) Variable . Other I Value
Use/Nature NSFRlINSTALL NEW 100,000 BTU CARRIER FURNACE AND 3 TON NC
of Work
Fees: Valuation $12,000.00 Plan Approval $0.00 Permit Fee Paid $180.00
Issued By: ~LJ Date 03/28/2007
o Permit Voided I Pc rcelld # 1281690000
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 wo k
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easeme t
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 6122 COUNTY ROAD M WINNECONNE . WI 54986 -9780 Telephone Number 920-582-4402
'\
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit ~umber, Type of
Inspection (Le. 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 rece ived. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
..
/
CU)' ot"Osnkosb
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-50&4
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~
~QtH
· Application( s) and fee( s) can be brought to City Hall. Room 205 or mailed to lnspec . on Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees ing doubled or $100.00 plus
normal permit fee, which ever is greater.
OR
JOB ADDRESS
OWNER
3BbS 5H6I2J;~BI2D
k>i< CITI ~S CoNST.
CONTRACfOR MOi AIR, INC.
3-20r07
6122 COUNTY ROAD M, WINNECONNF;, WI 54986
~~l-4402 FAX 582-0136
CHECK It! ALL APPLICABLE
USE CATEGORY
~ing1e Family ODuplex o Multi-Family
ORental
OComm ial
.'
FUEL
~as
DOil
ONew
OOthc:r
DElectric DSolid
DSolar
SYSTEM
o Industrial
DRcplace
TYPE .
~Forced Air ORadiant OSteam ~C OVent OElectric OHot Water OSuppl.DCon Burner
IS CHIMNEY BEING LINED ONo DYes w LINER SIZE & MANUF CTURER
Note: All chimneys shall be sized per. the BTU's beiDa vented.
CHIMNEY TYPE
REA T LOSS
BTU RA ~
DChimney A
DAs Approved
D As Per Plan
OChimney B
DExistins .
DVariable
pvc
~Direct Vent
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE
H ACt, OAJ 00
TU CfTtJ2JE R-
VALUE (Indudinll.bo..nd .11 m.t.....b.lncludl.C UCh1lhturos) "" I Z pdO a ~ :P /00 . c
ELECTRICAL CONTRAcrOR 160 I LDE 12/ 'S QB. 0 Electric IDsta1laUoD Vut caUOD form attacbed(lfRcplaocma
EJctrleiU UullJUodOlt ofMWlrqJl ~ sMJl ~ doIw by /~ed c