HomeMy WebLinkAbout0145223-HVAC (furnace) 10 CITY OF OSHKOSH No 145223
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1205 N EAGLE ST Owner EVERGREEN MANOR INC Create Date 03/22/2011
Contractor MCM AIR INC Category 500 - Residential- Heating & Ventilating Plan
Fuel 1.i Gas Li Oil 9 Electric Solar U Solid
System ❑ New 1 0 Replace n Other _
U Forced Air 9 Radiant 9 Steam u NC u Vent 1
u Electric u Hot Water u Suppl. J Con. Burner
Chimney Type 0 Chimney A 9 Chimney B 0 Direct Vent 0 Not Applicable
Heat Loss 9 As Approved 0 Existing • Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature SFR / Replace furnace. EIV signed by Seckar Electric.
of Work
Fees: Valuation $3,300.00 Plan Approval $0.00 Permit Fee Paid $61.00
Issued By: a/I[..Q/ Date 03/22/2011
❑ Permit Voided Parcel Id # 1608640000
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.
T.O. Bon 11 30.....' .x..
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PUSS MO) cock WI 54 903-1130
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36 6 0sa
Tax (920) 23u
HVAC PERMIT APPLICATION a ~ " after bold cazagorias All k b ` v las provided.
• Appliadon(s) and f can � bcnti '" /)/, O
Oshkosh WI ) and fcc(s) cc(s 8. n iht to City �, Room 205 a tz ai14 to Scrvi
Inspection S.
normal pcmtit fcc, which ever permit(s) result in fees bcin� doubled 100 00 2 1u:
OR p
JOB ADDRESS / p5" /), J. DATES / s:,!/
OWTVER - ,r d__, dr zz
CONTRACTOR 1 "�! 7�IR, INC. .[..
6122 000 WTy RODN,
E • WI 54986
COCK ® ALL APPLICABLE -4402 FAX 582 -0136
USE i CATEGORY
�
�i°gla Family ODuplcx OMulti- Family ClIkental .
Ocorc�nc,�i Olndustr;al
FUEL ` OElcctric OSolid
OOiI OSolar SYSTEM Qll
ORcplacc
� E O Othcr
� Ali ORadiant OSc
"m OA/C OVcnt QIIoctric OHot Water OS
IS CSIMNEY BEING LINED ,12‘o uppl.00on. B�zznc
Nom; All chimacy:'ball be :' o Wu vea:44 C I'U
,_,� �.� BTU's a 'LINER SIZE & MAN' UFA
HZAT SNpE OChimMy A
,� CI A3 A nn��� B V O
B� Mks PR O Applicable
D1Z:SCRIp�TION OF flue
ALL WORK BEING DONE i, 44- . 'I' <,
/s I
Ai air , 0 , O ■L� r L Ws
VALUE (Including labor and all 1: uterials•tail u4 n ugh*
• ELECTRICAL Lh Gaza* �� DO , D U
AL CONY-RACI'OR
"' i last+]l+Wa vcr111ciCoa t.r anac ►w
RE CEIVED
MAR 2011
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
City f
d.iiia.f Lu ..ees Unitas
215 Oracle AVM=
7OBox MO
ori:xo ar o�h 20. a- sose 130
Ot�ec 920.6 -SOSO
• " Fat 930.276 -7414
Electric Installation Verification
1 (We) k E . .1
(Electrical Contractor Name or Homeowner's Name)
S'a) COJJPrhv1 P c-0MM . D. Dinh ecoly W, S4-1,g6,
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
/. o5 /9, 12,.e53A
(Address (
#e work will be rformed
Pe )
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 $ /,j DQ
I hereby verify this work will be performed in compliance with the License requirements
Section 11 - 22 of the Oshkosh Municipal code and further verify the reconnecti J installation
will be done in compliance with manufacturer and Electric code requirements.
I ,
t .. 7 c,. ( Dift e. so ,5
(Signature of . mpmy Officer or Homeowner) (Print Name) (Date)