HomeMy WebLinkAbout0156696-HVAC /�'� CITY OF OSHKOSH No 156696
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2460 SHORE PRESERVE DR Owner ANDREW R/LAUREN A CLAYTON Create Date 07/15/2013
Contractor MCM AIR INC Category 500-Residential-Heating&Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric i Solar J �olid __ ,
System ❑ New � � Replace __J ✓ Other _
Forced Air Radiant Steam A/C � Vent '�
Electric Hot Water Suppl. Con. Burner
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable I
Heat Loss As Approved � Existing � Not Applicable Va�ue
BTU Rate As Per Plan � Variable __ � Other � Value
Use/Nature FR/ADD SUPPLYAIR RUNS TO LOWER LEVEL IN CEILING,ADD RETURN AIR RUNS LOW IN WALLS "check#23689 '
of Work
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,
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Fees: Valuation $900.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: _�1 Date 07/15/2013
❑ Permit Voided ; Parcel Id#1281030000
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.
7/12/13 Cityof Oshknsh-Inspection SerHCes Diusion-HVAC Permit Application
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5050
HVAC PERMIT APPLICATION
All information with * next to it 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 norma! perm:t fe�, �rhic" e�er is greate�.
If vou are a contractor participating in the Permit Fee Account Svstem and have adeauate funds,
type YES if you want this processed through your account �!
** 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.
_ _ __
*]OB ADDRE55 2460 Shore Presen�e
*OWNER Andrew Clayton __ !
_ __ _ _ _ _ _
*CONTRACTOR MCM Air, Inc.
*USE CATEGORY
��� Single Family �.��F Duplex ?�_;� Multi-Family ���.� Rental �.-� Commercial '.�' Industrial
FUEL
��''`Gas �;Electric �:�Solid ❑Oil �Solar
*SYSTEM
:_-! New �_' Replace €�? Other
TYPE
m �„ ,.�...
,�. .���
�....�Forced Air °:__:Radiant �Steam �__J A/C ���Vent �Electric .�Hot Water __ Suppl. �Con. Burner
*IS CHIMNEY BEING LINED
�}Yes ��� No
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7/12/13 Cityof Oshlmsh-Inspection Ser�ices DiHSion-HVAC Permit Application
__ _.... �_._ __. . - _ _.. �
- Liner Size: Manufacturer:
u. �
CHIMNEY TYPE :
-:�:" Chimney A ��r� Chimney B '-�;E Direct Vent '`�3 Other
HEAT LOSS
=_''As Approved ���.� Existing �.�<� Not Applicable
BTU RATE
':��'As Per Plan �';w�Variable
; _ __
Other: '
*DESCRIPTION OF ALL WORK BEING DONE
_,�,... . .. ��..__.
`ADD SUPPLY AIR RUNS TO LOWER LEVEL IN CEILING
'ADD RETURN AIR RUNS LOW IN WALLS
__. „..._. ......,_���..,._�.,...,._.... �,........ �,.,..... . �'
*VALUE (Including labor and all materials including light fi�ctures)
900 � _. �_ -
ELECTRICAL CONTRACTOR (for projects not requiring an EIV Form)
' Submit Reset ;
w�n�uv.ci.oshl¢�sh.wi.us/Corrxnunity_De�.elopment/Inspection_Ser�ices/Permit App_HVAC.aspx y2