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OSHKOSH
ON THE WATER
Job Address 1021 EASTMAN ST
CITY OF OSHKOSH
No
126789
HV AC PERMIT - APPLICATION AND RECORD
Owner ERIK A1ERIN M GIALDELLA
Create Date 09/14/2007
Contractor
MCM AIR INC
Category 500 - Residential-Heating & Ventilating
Plan
Fuel ~ Gas U Oil U_Elect~~ U Solar J U Solid__J
System D New ~ 0 Replace ~~~ D_Qt~~r ~~J
lliorced Air D Radiant l U Steam ==:J ONC--] U ~~~__~~~]
U Electric ~ Water I Wuppl. ==:J U c~l'!. BurneD
Chim ney Type rrgl!Lf!1Q~~~_~_QI1_~~__~__~Q Di~gt_Y~Q!_~._~-=_ 1[1:!~~ppIIc::~~I~=:J
Heat Loss 0 As Approved _______ Existing -':"-==:=~-::D-=-i\I~tj\iJiF~b1~=====] Value __.______
BTU Rate O_~~Per Pla~___: O__Variable_~_=:===-==-=. Q!~er=:_______ Value
--. ..----l
Use/Nature ISFR / REPLACE 80,000 -BTU FURNACE, EIV-SIGNED BY SECKAFfEIECTRfC-'*check #19421
of Work !
L
Fees: Valuation $3,700.00
~
Issued By: -..
Plan Approval______ $O.OQ
Permit Fee Paid __________ $65.50
Date 09/14/2007
D Permit VoidedJ
Parcelld # 1002490000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
AgenUOwner
Address
6122 COUNTY ROAD M
WINNECONNE
WI 54986 - 9780 Telephone Number 920-582-4402
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
i{,5.'. 5: <fJ
" City O(O$hkosh
Divisiou of luspection Services
P.O. Box 1130
Oshkosh, Wl 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
O{F!QtR
HVAC PERMIT APPLICATION
AU informatioD after bold catelOries must be provided.
Incomplete applicatioDS will DOt be: processed.
JOB ADDRESS \ 0 ~ I (0. ~1 'M 0. V\
L CI t (; '2 (TV'\ IJ' (;\. \
OWNER ~ V' \ C. + 'f ( V\ . la. '<V\ }D e. C.Cb VI si J
CONTRACfOR MCM AIR, INC. 6122 ~ ROAD M, WINNECONNE, WI 54986
~~~-4402 FAX 582-0136
CHECK ~ ALL APPLICABLE
USE CATEGORY
IS11Single Family o Duplex OMulti-Family
ORental
DCommercial
Dlndustrial
FUEL
2'Gas
oOil
oElectric OSolid
oSolar
SYSTEM
ONew
OOther
GaReplace
..
TYPE. .
~Forced Air DRadiant DSteam DAlC OVent OElcctric; OHot Water OSuppl.OCon. Burner -H 0. '(' T ""
IS CHIMNEY BEING LINED ONo 0ves . I..INER. SIZE 3 " &. MANUFACTURER c'c>~ ~ e i
Note: All chimneys shall be sized per. the Bro'l beiDa vCDled.
CHIMNEY TYPE oChimney A OCbimncy B ODircct Vent (BOther P \J C
REA T LOSS oAs Approved 5Exist:in; ONot Applicable
BTU RATE oAs Per Plan OVariable t2JOther Valuc.
DESCRIPTION OF ALL WORK BEING DONE R e:.f \ ac...e. ~ lsl'i' V\ ct e-e \N \ -\'~
rfo.lf''f'rP.Y' 5d MVR GJtO &0. C>C>O ~'T\) C u..Y'V\Qc--e
t:~
V ALUE (IDcludin~ labor and all matcrlals'lDc!udlDC Ucht flxtures) S .~ 7 tJ C) -
ELECTRICAL CONTRACfOR
QB Jt Electrlc IDStallatloD VcrUkatlOD form anacbcd(lf Rcplac:an
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