HomeMy WebLinkAbout0152733 - HVAC (replace furnace and AC) CDCITY OF OSHKOSH No 152733
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1250 ONTARIO ST — Owner SUSAN M LEWELLYN Create Date 10/03/2012
Contractor MCM AIR INC Category 502-Residential-Both Plan
Inspector John Zarate —
Fuel ✓ Gas ❑Oil 1 ❑Electric ] Solar _1 [] Solid
—System ❑ New I 0 Replace ! ❑Other J
✓❑Forced Air ❑ ❑Radiant j Er Steam [fA/C 1 ❑-Vent J
❑❑ Electric i LfHot Water Su I. r
[7 PP f Burner
Chimney T yp e Chimney O Chimney - --
B ❑ Direct Vent • Not Applicable —'
Heat Loss 0 As Approved • Existing ❑ Not Applicable Value
BTU Rate --
As Per Plan ❑ Variable • Other I Value
Use/Nature 1SFR/REPLACE FURNACE AND NC, ELECTRICIAN IS SECKAR ELECTRIC "'check#54200
of Work J
Fees: Valuation $5,500.00 Plan Approval $0.00 Permit Fee Paid $92.50
��i i
Issued By: !W
Date e 1
10/03/2012
❑ Permit Voided Parcel Id#1208230000
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.
City of Oshkosh
411111"....11
Division of Inspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130
•
Phone(920)236-5050
Fax (920)236-5084 OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate_funds, check here
if you want this processed through your account El
**Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE /D';? / .
JOB ADDRESS /77so net/ah,o
OWNER L$U 5aOT /d/' r/s
CONTRACTOR me a7 /9/1-- /o
CHECK Ed ALL APPLICABLE
U§E CATEGORY
'Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL j21/Gas DElectric ❑Solid SYSTEM ONew D eplace
❑Oil 0 Solar DOther
TYPE
Forced Air DRadiant ID Steam DA/C OVent DElectric ❑Hot Water DSuppl. ['Con. Burner
IS CHIMNEY BEING LINED ❑Noes -LINER SIZE 3" &MANUFACTURER FlexL
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent DOther
HEAT LOSS DAs Approved BExisting ONot Applicable •
BTU RATE DAs Per Plan ❑Variable DOther Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE R J2ep_ -bzm w/c i're/-
59 77>5A 4,4 oo 6TO 5
�:�� ,mfg 1 02
VALUE(Including labor and materials) $ SSA. oQ
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) Si J
07/07