HomeMy WebLinkAbout0144139-HVAC (furnace) CD CITY OF OSHKOSH No 144139
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1628 MENOMINEE DR Owner TERRY B OBERLIES ETAL Create Date 11/18/2010
Contractor MCM AIR INC Category 500 - Residential- Heating & Ventilating Plan
Fuel U Gas Lf Oil J Electric u Solar Li Solid
System 0 New 1 n Replace 1 n Other
u Forced Air u Radiant u Steam LJ NC U Vent
Li Electric Li Hot Water U Suppl. ( 1 Con. Burner
Chimney Type ( ) Chimney A () Chimney B • Direct Vent 0 Not Applicable
Heat Loss As Approved • Existing 0 Not Applicable Value
BTU Rate 0 As Per Plan O Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Seckar Electric.
of Work
Fees: Valuation $2,800.00 Plan Approval $0.00 Permit Fee Paid $52.00
Issued By: C/4 .L� Date 11/18/2010
❑ Permit Voided Parcel Id # 1512710000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number 920 - 582 -4402
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
I
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Osh3roak W1 54903
noes (920)236 40S0
Tax (920) 236-sou
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HVAC PERMIT APPLICATION
AU information altar bold categories stoat be provided_
Incomplete applications will not be processed
• Application(s) and fec(s) can be brought to Qty Hill. Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Commencing work without permits) will result in rocs being doubled or 5100.00 plu:
notnul permit fee, which ever is greater.
•
OR
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CONTRACTOR ticti AIR INC. 6122 COUNTY RAND K, WI13�CORNE, WI 54986
�tt -4402 FAX 582 -0136
CHECK ® ALL APPLIC LE
•
USE CATEGORY
• Family ODup ex ()Multi- Family Q1tcntal OCornmcrcial dInduseriaJ
•
• . FUEL )$(Gas 0 lcctric °Solid SYSTEM °New ,Replace
OOiI °Solar OOthc
TYPE
121Forccd Aii ORadiant °Stern OA/C °Vcmt QElcctric OYiot Water °Suppl.00on. Bumc
IS CHIMNEY BEING LINED` No DYa - LINER SIZE & MANLY? AC1URER
Note. All chuancys sball be sized paths BTU's being veatad.
CHIMNEY TYPE °Chimney A OChivauy B SIDircct Vast OOthc
SEAT LOSS DAs Approved vExistin DNot Applicable
BTU RATE 0 A Per Plan rYasisble DOthcr Value
DESCRIPTION OF ALL WORK BEING DOLE IY19 tCk )Mar 5 1S V 8 6 Q
•
VALUE (Including tabor and all materials' Including ULDM tlxtures) 5 v2,g®O
ELECTRICAL CONTRACTOR v atp' Electric lastallaties Vcrtnotioa tern. attacla6(>la
[1ldLiod 4ui.fa1.4.1 else e •p..lprau a►.1! w yr by
RECEIVED
NOV 18 2010
CA -. DEPARTMENT /tea s � DEPARTMENT OF
J ac, c 0 COMMUNITY DEVELOPMENT
INSPECTION SERVICES MVISION
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217 of ca MOW
POD= II30
ff otkoi W1 S19031130
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Electric Installation Verification
1(We) kS k }le r-T 1 L
(Electrical Contractor Name or Homeowner's Name)
£ o y0J PcUMM 2. ieD. (�I ,Jeco1J GU, Sy9gro
(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 / factures.
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 occpiied 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 / 35 .
I hereby verify this work will be performed in compliance with the License requirements of
Section 11 -22 of the Oshkosh Municipal code and further verify the reconnection / installation
will be done in compliance with manufacturer and Electric code requirements.
1 ,
• ' . 7t,' Diff7Or e. S it- . 1 NJ 7 '- J
(Signature of s quo*? Officer or Homeowner) (Print Name )
(Date)