HomeMy WebLinkAbout0156928-HVAC (furnace & a/c) � CITY OF OSHKOSH No 15ss2s
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1591 WESTHAVEN CIR Owner DONALD/LORAINE NEGENDANK LIVING 1 Create Date 07/25/2013
Contractor MCM AIR INC Category 502-Residential-Both Plan
Inspector Nicole Krahn
Fuel ✓ Gas Oil ✓ Electric Solar Solid
System � New � �✓ Replace _� � Other
✓ Forced Air Radiant Steam ✓ A/C Vent '
Electric � Hot Water Suppl. Con. Burner �
Chimney Type ChimneyA � Chimney B � Direct Vent � NotApplicable
HeatLoss AsApproved � Existing � NotApplicable Value
BTU Rate As Per Plan � Variable � Other i Value
Use/Nature SFR/REPLACE EXISTING 60,000 BTU FURNACE AND 2-1/2 TON A/C,ELECTRICIAN IS SECKAR ELECTRIC '"check#23707,
of Work I�3704 �
I�
� I
Fees: Valuation $6,300.00 Plan Approval $0.00 Permit Fee Paid $126.00
Issued By: ���� Date 07/27/2013
❑ Permit Voided I Parcel Id#1321980000
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,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 � H�� �--�
ON TNE�lATER
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 ar$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit fee Account Svstem and have adequate funds, check here
if vou want this processed throu.2h 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 07/24/13
JOB ADDRESS 1591 Westhaven Circle fl�ECEI�ED
OWNER Loraine NeEendank
JUL 25 2013
CONTRACTOR MCM Air,Inc.—920-582-4402
DEPART�1E\T OF
CHECK■ALL APPLICABLE C0�1�tU\ITY DEVELOP�fEVT
INSPECTIOV SERVICES D1�'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 existing furnace and AC. Furnace—Carrier Single Stage Comfort 60,000 BTU
A/C—CarrierComfortl3 2.5Ton
VALUE (Including labor and materials)$6300.00 — ���„ �
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) Seckar Electric
o�/o�