HomeMy WebLinkAbout2013-HVAC (furnace) � CITY OF OSHKOSH wo 155833
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1037 PIERCE AVE Owner BARBARAA HAHN REV TRUST Create Date 05/28l2013
Contractor MCM AIR INC Category 500-Residential-Heating 8�Ventilating Plan
Inspector Nicole Krahn
Fuel ✓ Gas Oil Electric Solar Solid �I
System � New � ✓�Replace � � Other
✓ Forced Air � Radiant Steam A/C Vent
Electric Hot Water Suppl. Con.Bumer I
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
Heat Loss AsApproved � Existing � NotApplicable � Value
BTU Rate As Per Plan � Variable � Other Value 60,000
Use/Nature FR/REPLACE EXISTING FURNACE **check#23639 - - - -
of Work '
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Fees: Valuation $3,500.00 Plan Approval $0.00 Permit Fee Paid $78.00
Issued By: ��(�,� Date 05/28/2013
❑ Permit Voided i Parcel Id#1606390000
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
AgenUOwner
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.
Ciry of Oshkosh
Division of Inspection Services �
P.O.Box 1130 �
Oshkosh,WI54903-1130
Phone(920)236-5050
Fax (920)236-5084 HK �I
ON THE WnTER
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 vou are a contractor participating in the Permit fee Account Svstem and have adeguate funds, check here
if vou want this processed throuQh vour account n
**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 OS/23/13
JOB ADDRESS 1037 Pierce Ave. ����I��D
OWNER Barbara Hahn
CONTRACTOR MCM AIR,INC. MAY 2 4 2013
CHECK■ALL APPLICABLE ��P.;�T�+SE�T OF
C0�4�iU�17'Y DE�'ELOPITEVT
INSPECTIO�SERF'ICES Dl�'ISIOV
USE CATEGORY
■ Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
FUEL ■ Gas ❑Electric ❑Solid SYSTEM ❑New ■ Replace
❑Oil ❑Solar ❑Other
TYPE
■Forced Air ❑Radiant ❑Steam ❑A/C ❑Vent ❑Electric ❑Hot 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 ❑Chimney B ■Direct Vent ❑Other
HEAT LOSS ❑As Approved ❑Existing ❑Not Applicable
BTU RATE ❑As Per Plan ❑Variable ❑Other Value
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
Replace furnace with Carrier 59tp5a060 furnace 60000 BTU's
VALUE (Induding labor and materials) $3500.00
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o�/o�