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Home My WebLink About0143260-HVAC (boiler) C ") CITY OF OSHKOSH No 143260 OSHKOSH HVAC PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1231 JACKSON ST Owner WILLIAM H CHRISTIANSON Create Date 09/22/2010 Contractor MCM AIR INC Category 500 - Residential- Heating & Ventilating Plan Fuel ✓ Gas Lf Oil 1 ] Electric ❑ Solar 1 Solid System ❑ New 1 151 Replace Other ❑ Forced Air LJ Radiant LJ Steam J A/C J Vent 1 ] Electric U Hot Water U Suppl. u Con. Burner Chimney Type u Chimney A • Chimney B O Direct Vent 0 Not Applicable Heat Loss J As Approved 0 Existing 0 Not Applicable Value BTU Rate K ) As Per Plan 0 ) Variable • Other Value Use /Nature SFR / Replace boiler. EIV signed by Seckar Electric. of Work Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $55.00 Issued By: G Date 09/22/2010 ❑ Permit Voided I Parcel Id # 1202970000 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 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. P.O.1at 1130 411P) Oshltosk WI 54903 -1130 Thew (92O) 236 -5050 Tax (920) 236 -5014 HVAC PERMIT APPLICATION All inracrostios altar bold cats=orias must bs psovidcd. Incotopleta applications will nos ba ?mewed. • Application(:) and fcc(s) can be brought to City Hill, Room 205 of mailed to Inspection Scrvica, PO Box 1128, Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in fees being doubled or 5100.00 pltr llornul permit fcc, which ever is greats. OR • i t vale went this ',rewired three :lt your ceeevWr DATE 9 - 1,1' /0 3011 ADDRESS 1 2, 3 p - 1 _ % OWNER Ui I ChNr1s I otvl 0 CONTRACTOR 'O4 AIR, INC. 6122 COUNTY ROAD K, WINNECONNE, WI 54986 43e: - 4402 FAX 582 -0136 CHECK B! ALL APPLICABLE • USE CATEGORY bangle Family ODuplcx OMulti- Family QRental OCoiumcrcial Olndustri • . FUEL XGas OElcctric OSolid SYSTEM OTNcw At-pl OOiI OSo1 OOtha TYPE OForced Air ORadiant OStcam DAJC Mica QIIoctric Piga Water OSuppl.00on. Burner IS CHIMNEY BEING LINED 10 OYcs - LIIdER SIZE & MANUFACTURER New All chimneys shall be sized paths BTU's Wag vented. CHIMNEY TYPE OChirnncy A B ODirect Van OOthcr HEAT LOSS OAs Approved OrExiserag ONot Applicable BTU RATE OAs Per Plan ulVarlable OOtha Value /� DESCRIPTION OF ALL WORK BEING DONE I t, t\ S"tc� 1 lair tier Vt2,A Pk N1 165 i45 X30 + e r VALUE (Including labor and all tnateriats'tacludla= tight tlxtures) 30 ELECTRICAL CONTRACTOR 'a e• C -0.'i Q t.lactric laitauan.a Vs:Mc / dos f.res artac,.atu [Lc , csJ 4utsJJatla+ egul alai! ►r caw by £c curoc oru� ctt (Sunk Aveeos POBoz U30 Ken • Otkc l WI 54903 -1130 in: � •�i. Fotna 920 ]6 05 0 Electric Installation Verification 1 (We) 5 � e1 L 1 C_ (Electrical Contractor Name or Homeowner's Name) 59ZO COJPIX) Pump y Rt.. GJ oklecoiv Ai Sygg6 (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: 3( LaC � - (Address work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) _A._ Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser. Reconnection or new circuit for replacement Electric Water Heater or power vented water heater. Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables will require a separate permit. Reconnection or new circuit for the replacement of other permanently wired appliances / fixtures. New circuit for the addition of A/C to an individual dwelling unit, including required service electrical outlets. Note: Homeowners can only do their own electric on a single family owner occupied home. Work on a condominium, duplex, rental, or multi -use building would require a licensed Electrical Contractor. Other The value of this work is S ) O O . I hereby verify this work will be performed in compliance with the License requirements of Section 11 of the Oshkosh Municipal code and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. 1 I. ' . f �- ( l) 1 7t r 4 / et —41- 1 - ( 0 (Signature ofC• 4 - 4 . / tie. rtipany 4f or FlomeOwnsr) (Print Name) (Date)