HomeMy WebLinkAbout0086416-HVAC (furnace & a/c) 0 CITY OF OSHKOSH No 86416
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1847 SIMPSON ST Owner ROBERT J /SANDRA MELLER Create Date 05/30/2001
Contractor MCM AIR INC Category 502 - Residential -Both Plan
Fuel 11 Gas Oil Electric Solar I Solid
System ❑ New 1 Q Replace ❑ Other
1 Forced Air ❑ Radiant ❑ Steam ✓j NC ❑ Vent
Electric I Hot Water I Suppl. I Con. Burner
Chimney Type Z, ) Chimney A () Chimney B 0 Direct Vent • Not Applicable
Heat Loss 7 , ) As Approved • Existing U Not Applicable Value
BTU Rate ) As Per Plan • Variable 0 Other Value
Use /Nature SFR / Replace carrier 58MXA080 80,000 BTU furnace adn 38TKB030 2 -1/2 ton 30,000 BTU NC
of Work
Fees: Valuation $4,100.00 Plan Approval $0.00 Permit Fee Paid $66.50
Issued By: �i Date 05/30/2001
❑ Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number (920) 582 -4402
6 6.5'!J
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
oz Fax # (920) 236 -5084
Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 5/19/ m
r I , 0
JOB ADDRESS 1 `1' ` i 1(\/ A v e
OWNER B(b\f; , U, e.M e \C‘'
CONTRACTOR N11.0.„ VI, Air, : li, -•
CIRCLE ALL APPLICABLE •
USE CATEGORY INGLE FAMILY) DUPLEX MULTI- FAMILY COMMERCIAL INDUSTRIAL
FUEL OIL ELECTRIC' < SOLAR SOLID
SYSTEM NEW REP OTHER
TYPE dRCED AIR RADIANT STEAM Q C VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER 4 N
IS CHIMNEY BEING LINED 1 e'S LINER SIZE 1 t
3 MANUFACTURER QC!) el) \
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE CHIMNEY A CHIMNEY B DIRECT VENT :OTHER
HEAT LOSS AS APPROVED 'EXISTIN . NOT APPLICABLE
BTU RATE (S AS PER PLAN OTHER VALUE
a
NATURE OF WORK : a t't e Y` -s" c: M X A 3 3 8 O O s g L U Lot h a CG
3 $ hRO3o .5 to f i 30, o c BT() . / c
VALUE (Including labor Q and materials) $4'00,00
ELECTRICAL CONTRACTOR v e. ek c t D e ,
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$1, 000.01 t o $10,000 .0 0..».»._.».».„.„._.„._.».»._.»._.»:»:_ for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25,000 .0 0 .._._.».»._._.»._.».»._.».»._._._...._.»....». ».__. »._._. »._._. »._. »._. » ..$15 5. 0 0 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25, 0 0 0.00............. plus $0.50
per $100.00 valuation or part thereof
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
FROM : SECKAR ELECTRIC FAX NO. : 9202313950 Jun. 18 2001 01:40PM P1
N.
Q _,.) 1 i _ c f_ _ ./ ' 1±. i,_,)
City or Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
/''� /1 �� Oshkosh WI 54902 -1130
W r��/ H Office 920.236.3050
ON ♦wE WAVER Fax 920. 236 -5094
Electric Installation Verification •
Seckar Electric Company Inc.
(X) (We)
5920 Courtney P PirAtriielag,VertitgaMsconsin 54986
(Address) (City) (State) (Zip Code)
MCM AIR INC.
have been contracted to perform electric installation work for ,
(Name of parry contracted to)
at the following address: 1847 Simpson Street
(Address where work will be performed)
The nature of the work consists of : (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric 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 other permanently wired appliances / fixtures.
Other
The value of this work is $ / JS• .
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
s Diane R. Se ekar JUNE 15, 2001
(Signature Company Officer) �~ (Print Name of Officers _ (Date)