HomeMy WebLinkAbout0157182-HVAC (furnace) /�"� CITY OF OSHKOSH No �s��82
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2330 MINERVA ST Owner DEREK DlJACKLYN F BRUBAKER Create Date 08/09/2013
Contractor MCM AIR INC __ Category 500-Residential-Heating 8 Ventilating Plan
Inspector John Zarate
Fuel ✓ Gas Oil Electric Solar Solid '
System ❑ New � �✓ Replace � � Other ' '
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✓ Forced Air Radiant Steam A/C Vent _
Electric Hot Water Suppl. 1 �n.Bumer ',
Chimney Type � ChimneyA � Chimney B � Direct Vent � NotApplicable � .
Heat Loss As Approved � Existing � Not Applicable ; Value
BTU Rate As Per Plan � Variable � Other � Value
Use/Nature FR\Replace furnace w/Carrrier 2-stage performance 60K btu "check#23724
of Work � '
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Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $62.00
Issued By: Date 08/12/2013
� Permit Voided i Parcel Id#1214820000
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 Tetephone 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 �
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 (~'����((�j�
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Ot�THE WATrR
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 participatinQ in the Permit fee Account System and have adequate funds, check here
if vou want this processed throuQh 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 pernut application. Applications submitted without an EIV when such is required, will not be
processed for Pernut Issuance and will be returned for completion.
DATE 08/07/13
JOB ADDRESS 2330 Minerva REC�IVED
OWNER Derek Brubaker
AUG 0 9 2013
CONTRACTOR MCM Air,Inc.—920-582-4402
DEP,�R7A1E�T OF
CHECK■ALL APPLICABLE CO>1>tUViTY DE�'ELOP�tEVT
1NSPECTIOV SERVICES DI�'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 with Carrier 2 Stage Performance 60,000 BTU's
VALUE(Including labor and materials) $3000.00
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form)
o�/o�