HomeMy WebLinkAbout0152975 - HVAC (replace furnace and AC) (9 CITY OF OSHKOSH No 152975
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Owner MATT J/JENNIFERA DUBIE Create Date 10/16/2012
Job Address 2915 E PHEASANT CT --- — --—
Category 502-Residential-Both Plan
Contractor MCM AIR INC
Inspector Nicole Krahn _
— — — Solid
_ -- -- Electric Slar
Fuel Er Gas 1 Q OiI o
❑ -- — -
Replace ❑ Other J
System ❑ New 0 ce p
—--
❑✓ Forced Air 1 ETRadiant Steam KNC 1 UVent
Er Electric Em=lot Water Suppl. —1 JCon.Burner i
Chimney • Direct Vent 0 Not Applicable '
Chimney Type �— ne Y B ChimneyA ❑ —- — — -- -- � Value - —
• Not Applicable
Existing Heat Loss As Approved ❑ 9 — —
— — — --
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use/Nature SFR/REPLACE FURANCE AND A/C,ELECTRICIAN IS SECKAR ELECTRIC **check#23298
of Work
Fees: Valuation $5,300.00 Plan Approval $0.00 Permit Fee Paid $89.50
Issued By: 0-rnIAJ Date 10/16/2012
❑ Permit Voided I Parcel Id#0657150000
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.
Date
Signature
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
Division of Inspection Services
P.O.Box 1130 v �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 DJHKOJH
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 adeguatefunds, check here
if you want this processed through your account Ft
**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.
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DATE /0 `�� '42
JOB ADDRESS c2'TI�? C Ph&3sant
OWNER /9"),a >
CONTRACTOR foe a-/ Air /'did
CHECK H ALL APPLICABLE
USje CATEGORY
R:Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL J2r6as ❑Electric ❑Solid SYSTEM ❑New E1Replace
❑Oil ❑Solar ❑Other
E
fefF'orced Air DRadiant 0 Steam J A/C ❑Vent DElectric DHot Water ❑Suppl. ❑Con.Burner
IS CHIMNEY BEING LINED ( No ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A 0 Chimney B 015irect Vent ❑Other
HEAT LOSS DAs Approved DExisting [Not Applicable
BTU RATE DAs Per Plan OVariable DOther Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE j�� f L �Z 14)) Afar
5R7795A 840&o'e, n 15
1.j . AK uu/0221 " ( # 13 3 Tan..
VALUE (Including labor and materials) $ 5,30 0
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
07/07