HomeMy WebLinkAbout0143723-HVAC (furnace) (1) CITY OF OSHKOSH No 143723
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1102 E NEVADA AVE Owner GEORGE M POUBA Create Date 10/19/2010
Contractor MCM AIR INC Category 500 - Residential- Heating & Ventilating Plan
Fuel ✓ Gas 1 J Oil 1J Electric LJ Solar 1 Solid
System ❑ New 0 Replace n Other
u Forced Air J Radiant LJ Steam J A/C J Vent
1 1 Electric 1_1 Hot Water LJ Suppl. I Con. Burner
Chimney Type 0 Chimney A • Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss As Approved 0 Existing 0 Not Applicable Value
BTU Rate As Per Plan • Variable 0 Other Value 60,000
Use /Nature SFR / REPLACE FUNACE AND INSTALL 3" CHIMNEY LINER, EIV SIGNED BY SECKAR ELECTRIC * *check #22086
of Work
Fees: Valuation 1 r 1( )( $3,200.00 Plan Approval $0.00 Permit Fee Paid $58.00
Issued By: l Date 10/19/2010
E Permit Voided I Parcel Id # 1511390000
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. Bon 113 .wc, •
wi 54903 -1130 IIP)
those M20)2364050 5� (
fax (920) 236 -508,4
HVAC PERMIT APPLICATION ~ W
AU tar after bold eatsgosiss muu be provided.
Inconclets applications •411 not be processod.
• Application(:) and fcc(s) can be b� +ou '
Oshkosh WI 54903 -1128. Commencing to City w 205 a tnuuod to Inspection Services, PO Box 1128.
normal permit fee, which ever is maw. i s =) wiU result >a fca betn8 doubled or 1100.00 p1u•
OR
DATE /4 ./5//e
JOB ADDRESS 0 - E I fad ,
OWNER a -" err s # "ea
CONTRACTOR Fal AIR, INC. 6122 COUNTY ROAD )4, WIN E, WI 54986
b - 4402 FAX 582 - 0136
CEECK ® ALL APPLICABLE
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US 1 CATEGORY
elifSinglc Family ODuplcx DMulti Famil 0Rental OCottamerci 0lndustr;
• • FUEL as OElectric OSolid SYSTEM ONcw Erf
000 0Solar
OOtha
TYPE
Z orced Air ORadiant OStcam OA/C OVtxmt CAlectric OHot Water OSuppl.00on. Bums
IS CfflM EY BEING LINED ONo,EKts - LINER a
Notr. All chimneys shall be sized per•tbs BTU's being vented. MANUFACTURER FLE.x L - Ltner
CIONINEY TYPE OChimney A 4 •.' .... B L t Vent OOthcr
SEAT LOSS DAs Approved ••• .
BTU RATE DAs Per Plan QNot Applicable
0larlsble OOtha Value
DESCRIPTION OF ALL WORK BEING DONE //75/ ?1/ Barr r 5 Js.CVQo6
,v7aC . eoc. �GTLC . r7j eh /2e I./i'Ier
VALUE (Including tabor and all taaterials•tacludtag light tlxtura) BOO, CO
ELECTRICAL CONTRACTOR
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• O+hkoi W1 S4901 -1130
am� g 920 920.T.4-50s0
Electric Installation Verification
1 (We) n � C- l L
(Electrical Contractor Name or Homeowner's Name)
51a0 CO() Pt UMi i . R D. OW tJecolvd■ (AL Sy9g6,
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
.X_ 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 $ / 5 , D '
I hereby verify this work will be performed in compliance with the License requirements of
Section 11-22 of the Oshkosh Municipal code and furthor verify the reconnection / installation
will be done in compliance with manufacturer and Electric code requirements.
t
I .. 7 ( DI c 4. s p,p /0 to
(Signature of C. nippy Officer or Homeowner) (Print Name 1 ` ~
) (Date)
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