HomeMy WebLinkAbout0143491-HVAC (furnace) 0 CITY OF OSHKOSH No 143491
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 913 DOVE ST Owner JAY R SCHULTZ Create Date 10/07/2010
Contractor MCM AIR INC Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas U Oil 1 1 Electric f Solar U Solid
System ❑ New 1 7j Replace ❑ Other
u Forced Air u Radiant ❑ Steam ❑ A/C _1 Vent
Electric ❑Hot Water Suppl. Li Con. Burner
Chimney Type 0 Chimney A O Chimney B ❑ Direct Vent 0 Not Applicable
Heat Loss 0 As Approved • Existing ❑ Not Applicable Value
BTU Rate ❑ As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. Install 5" chimney liner. EIV signed by Beez Electric.
of Work
Fees: Valuation //�� ���� $2,000.00 Plan Approval $0.00 Permit Fee Paid $40.00
Issued By: U�rit.Q / Date 10/07/2010
❑ Permit Voided Parcel Id # 1603070000
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.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050 •
Fax (920) 236 -5084 • • O1 —KQI
O N 7111 'NMM f (2
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
• Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box; 1 128,
Oshkosh WI 54903 -1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds, check here
if you 7yanl This processed through your account fl
DATE /0 - `1 -1 0
Q
JOB ADDRESS 1 13 DO VC- ST
OWNER JAS 1 K2+S 50A-+ LTL +
CONTRACTOR MARX MECHANICAL INC
CHECK Ef ALL APPLICABLE
USE CATEGORY
{ lgSin Family DDuplex ❑Multi- Fa7»i1y DRental DComrercial DIudu.stri.
FUEL I 'Gas DElectric ❑Solid SYSTEM [New OReplace
00i1 O Solar DOther
TYPE
atForced Air DRa.diant OSteanl DA/C DVent DElectric OHot Water DSuppl. DCon. B ler
IS CHIMNEY BEING LINED DNo Wes - LINER SIZE J tt & MANUFACTURER Fc+ L
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE @Chimney A DChnmmey B DDirect Vent DOther
HEAT LOSS DAs Approved Existing DNot Applicable
BTU RATE DAs Per Plan DVariable :E Other Value 1 006 /STU
DESCRIPTION OF ALL WORK BEING DONE tRePLAce I m' I v t
• `�•
OCT 6 2010
VALUE (Including labor and materials) $U00
ELECTRICAL CONTRACTOR �( � & Le�1�(G S ' E C l�
INSPECTION SE RV10E ✓ ;iE ?;
0 For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
10/09
1: