HomeMy WebLinkAbout0100813 HOSHKOSH
ON THE WATER
.lob Address 440 OLSON AVE
Contractor MCM AIR INC
Fuel ~J Gas
System ~J New
~J Forced Air
~J Electric
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Radiant
Hot Water
Owner SUE ANN DONKER
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
100813
04/15/2003
Other J
Vent J
Use/Nature SFR/Install 80m btu furnace. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,700.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$45.50
Date 04/15/2003
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
C~yO~~
Division ofInsl~on ~
P.O: Box 1130
~ WI 54903-1130
(920) 236-$084
JOB ADDRESS,
owlet ~ ~
CONTRACTOR MCM AIR,
q¼O
INC 6122 CQUNT¥ ~D M WINNECONNE, WI 54986
582-4402 FAX 582-0136
EIC.,~ Bm'mr
I~Hot Water CISuppl.
& ~AC~rR~
TYPE
orccd Air . ElRadiant I:]Sta~m E].~C EIV~n~ ClEl~ric
IS CHIMNEY BEING LINED [3No E]Ycs - LINER SIZE '~ I~
No~: All chi-,-,,ys shall b~ sized pa' the B'I-O'$ b~in~ v~t~d.
CHIMNEY TYPE EIChimncy A ElChinm~9, B . EIDircct Vcnt
H~AT LOSS I-IA~ Approved nF. xisting CINot Applicable
BTU RATE ~As Per Plan ElVariable E]Othcr Valuc
DESCRIFFION OF ALL WORK BEING DONE.
ElOtlzr
VALUE (I~dudi~= l~bor and all mterisls including fight flgtm~) $ ~---q (~O
ELECTI~CAi: CONTRACTOR" ~---
:...~:~ ... ~.~,. ,~. ~t "O~ eu~cnca or not app~cab~c,-a"separate Ele~:rical Permit'is requirecL
Electric Instaihflon ~eriflcatlon
~o~ ~K/~e ,,~'~cr~ co. INC. ,,
hive bom oo~r~ to perform eleotrie hsuilmtoa wol:k for
Th~ aa.tu~e o£~ wod~exnuim oe. (.Check One or Desczibe the N~ of W~)
~ or~ ~ ~ ~~ ~o w~ ~m m ~wm v~
~~ ~ ~ ~ ~ of~ p~~y ~ '
eleot~ outlet..
, , ~
I h~oby v~fy ~if work will be p~on:~od by in employee of this company and farther veri/y