HomeMy WebLinkAbout0153494 - HVAC (furnace) 0 CITY OF OSHKOSH No 153494
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1040 N WESTFIELD ST Owner EVERGREEN VILLAGE Create Date 11/12/2012
Contractor MCM AIR INC Category 510-Ind.&Comm-Heating&Ventilating Plan
Inspector Nicole Krahn
— Li Solid
0—Electric Solar
Fuel � Gas _I ❑ Oil E
J � _—— -- —
System ❑
New J ❑✓-' Replace J ❑ Other
_ — Vent
Steam 0-A/C J1 0-
✓Forced Air J � Radiant � [�
❑—Electric J LIHot Water J Suppl ❑ Con.Burner_i
Y B
Chimney Direct O Not Applicable
Chimney Type � Chimney A ❑ • Dirt Vent
– -- — -- Value
• Not Applicable J
Heat Loss � As Approved 0 Existing ---
_ 60,000
BTU Rate 0 As Per Plan O Variable • Other Value —
Use/Nature COMM(APT#311)/REPLACE FURANCE,ELECTRICIAN IS SECKAR ELECTRIC **check#23343
of Work
Fees: Valuation $3,165.00 Plan Approval $0.00 Permit Fee Paid $58.00
(1�„ , ` Date 11/12/2012
Issued By: J�� JJ f��l(.�
❑ Permit Voided Parcel Id#1608640200
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Date
Signature
Agent/Owner
Address 6122 COUNTY ROAD M — WINNECONNE WI 54986 -9780 Telephone Number 920-582-4402
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final, etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Division of Inspection Services Q J
P.O.Box 1130
Oshkosh,WI 54903-1130 O HKO H
Phone(920)236-5050
Fax (920)236-5084 ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s)and fee(s)can be brought to City Hall,Room 205 r mailed
in Inspection ti being doubled Pro$Box 1 plus the
PP
Oshkosh WI 54903-1 128. Commencing work without perms
normal permit fee,which ever is greater.
OR
1 ou are a contractor ,articisatinf in the Permit ee Account S stem and have ade,uate unds check here
i ou want this processed throu_rh our account •
-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
**A dviso ry
Contractor or Homeowner(for installations allowed to be performed EIV whenesuch is required, ill not be submitted homeowner)must be
with the permit application. Applications submitted without processed for Permit Issuance and will be returned for completion. DATE /l //Q
`
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4 I D Go� l�lid 31/
JOB ADDRESS � � R����fY��/��,1
1L 126 ��' '/
OWNER � — MCM AIR IN .
CONTRACTOR . ounty Rd M
CHECK ALL APPLICABLE Winneconne, WI 54986
USE CATEGORY P y ❑Commercial ❑Industrial
Single Family ❑Du lex Multi-Family ❑Rental
1 SYSTEM ❑New Replace
FUEL Gas ❑Electric ❑Solid ❑Other
❑Oil ❑Solar
TAPE
0111Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot Water ❑Suppl. ❑Con•Burner
IS CHIMNEY BEIN be IN aDe the B❑T[J's being PvventRdSIZE __
&MANUFACTURER
Note: All chimneys y �
irect Vent ❑Other
❑Chimne B mD
CHIMNEY TYPE ❑Chimney A
HEAT LOSS DAs Approved ❑Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value_.
DESCRIPTION I SCOPE OF ALL WORK BEING D10660 ONE /L/ 0/ . -/ �`Ar/ Cu
6' 7'
VALUE (Including labor and materials)
G19
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o7/