HomeMy WebLinkAbout0148967-HVAC%"+ CITY OF OSHKOSH No 148967
OSHKOSH
ON THE WATER
Job Address 2163 W 9TH AVE
Contractor MCM AIR INC
Inspector Brian Noe
HVAC PERMIT - APPLICATION AND RECORD
Owner THOMAS O /PATRICIA HALLQUIST REV TI Create Date 01/17/2012
Category 512 - Ind. t£ Comm -Both Plan W5-3457-121 1 -H
Fuel
✓ Gas
Oil
Electrc Solar Solid
System
Q New —_
J
Replace _ aOther
✓ Forced Air
LJ Radiant I
✓ A/C Vent 1
Electric
L Hot Water
Suppl. Con. Burner
Chimney Type
UChimneyA _
O Chimney B
O Direct Vent Not Applicable
Heat Loss
As Approved
O Existing
O Not Applicable Value
BTU Rate
O Other Value
As Per Plan
O Variable
Use /Nature jInstall HVAC system for new addition per Approved
Plan. Check #22880
of Work
Fees: Valuation $7,100.00 Plan Approval $0.00 Permit Fee Paid $116.50
Issued By: ate/ Date 01/17/2012
❑ Permit Voided JI Parcel Id # 1311840000
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
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE
Date
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.
C'aN ul (.,hhkoh
Di ision of-Inspeccion ea ic4s
1-0 130,\ 11 -,0
oshko"h. NVI - I to
Phone (9201� -',�o-5050
la�i 020'1216-S084
HVAC PERMIT APPLICATION
All information after b(fld categories must he providted,
hicompleie applications N%itl not k?e processed.
//-e" 66
t-11' H
Page I of I
• Application(s) and fee(s) can be brought to .'its Hall, Room 205 or mailed To frispection scrvices 1`0 lit?t I 28.
)shk'o h W1 S 4903-1 128. Commencing vork %N itflout peen. it(s) Neill result in tee-, being doubled iv'sl 00,00 plits the
normal permit tee. whicli tner is greater,
OR
ve 't 0'10r�acSu qT;n ;R e i1v .. . Permil fee A, C�Iliinf
'S � S f e yn a n a y" :de., a it I k'
...........
ou it 'a n! o ....... —0
** Advisory - For appli-cabte projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an ETV when such is rtquired, will not be
processed for Permit Issuance and will be returned for completion,
JOB ADDRFSS----9��t0q"i &T Q-
O%N-NER__
1 0
CONTRACTOR MCM AIR, INC.
&�2 C'r7 RD TO
CHECK 0 ALL APPLICA RLE WINNECONNE, W1 54986
920-582-4402
USE CATEGORY
❑Sal le Falllilv DDupilex Clklulti-Yamil� IlRental
FU F I '0.41's CElectric 0SAid SYSTEM
00il 05"Olar
DATE /"q
... . .......
��J � ':5y57- /,;? t I - 1-/
oronnnercial 01ndustrial
La""'ev, DReptace
0011ter
TYPE
;X 0170A Air ORadiant C]Stcam F(V;C DV -nt 11 Icciric ElHot tiX'ater E)Suppl. ❑Con, 13t;nler
& MA,NUFA('A'(.'Rj..R Flex L
.......... . . . .... ... . ........... . .......................
NotvAll chiqlrkeds 5h all be Sized pcg- the BTU*s being vevatd,
('111 NINE It' T Y11F, 1301ininev'A C]Chimne%, B ODirect',"em 00ther
HEAT LOSS OA,,, Apfjro d -2r 1:3Nct Applicable
13TI. RATE 0As Pei- Plan Elvw,iable 00ther Vahie
..... .. ......... ... .
DrSCRIPTION? SCOPE OF ALL WORK HEING DONE, ... ...... I'll
%'AlA,E (Including labor and material) x 7 0.6 r lJv
111.1 ..........
F I.FXI kit'Al. CONTRACTOR (for projects not rvqUirint, an rAV form) ME%k
---RE -. NVEP
JAN 17 2012
DEF* -MEN F OF
COMMUNITY DEVELOPMENT
INSPEC-1ION SERVICES DIVISION
http://www.pdfescape.com/open/RadPdf.axd?rt=c&dk=OOBC7FBDIZTIOZANON4FO57ZB... 1/13/12