HomeMy WebLinkAbout0101438-HVAC (furnace)OSHKOSH
ON THE WATER
.lob Address 812 MOUNT VERNON ST
Contractor MCM AIR INC
Fuel ~J Gas ~
System ~J New
~J Forced Air 1
~J Electric I
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner BRIAN J/SHELIA NIMKE
Category 502- Residential-Both
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved O Existing
BTU Rate I~ As Per Plan O Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
101438
05/13/2003
Other J
Vent J
Use/Nature SFR/Install 60m btu furnace and 24m btu a/c. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$5,500.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$87.50
Date 05/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number
(920) 582-4402
Division of lmpection ~
P.O. Box 1130
Oshkosh, WI 54903-1130
?bo~ (m0) z~-~o~o .
~=,,x (9~o)z~-~os4 HVAC PERMIT APPLIC~i~'JQ~h/~? ~ ~
normal pcrmit fcc, which Mcr is greater.
OR .... ...
[f vou are a contractor varttcivatin~r tn the'~ermi[ fee ,~ceount System and have'~de~ate funds, check her~
if you want thts processed through your account ~
CO~~OR~C~ AIR~ INC 6122 COUNTy RD ~ ~INNECONNE~ ~I 54986 582-4402 FAX 582-0136
USE CATEGORY
l~ingle Family
I-IDuplcx CIMulti-Family I-IRontal I-ICommercial .El. Industrial
FUEL ~ EIElectri¢ ClSolid SYSTEM ClNcw ]i~Rcplacc
ElOil r'lSolar r'lOther
TYPE
~Forccd Air . ElRadiant I=lStcam E]A/C I'lvcnt E]Elcctric
IS ~Y BEING LrNED EINo I~lYcs - LIN-ER SIZE.
Note: All chinnncys shall be sized per lite BTU's being vented.
ClHotWatcr ElSuppl. EICon. Burner
~ TYPE E]Chinme~ A I-IChimney B
FrKAT LOSS r'lAs Approved ~lExisting
BTU RATE I-lAs Per Plan l~ariable
Y Z% 1 [
· EIDireot V~nt
I'lNot Applicable
r'lOther Value
VALUE (Including labor and aH materials including light flat.es) $
ELECTRICAL CONTRACTOR
I~ For applicable proj¢c'ts,' an Electric Installati°n Verification form, signed by thc El' ~c~ttical'Contractor, must bc
atlachcd. If not attached or not applicable, a scpam~ Electrical Pcrmit is rcquirccL
Electric ZnsUdhtion ~erlflcstlon
hivo boon cont=~ to l~rfm= eloo~o ~ woz~ for ~~~~:~~.
(Neme ofp~m~ oon~-a~t~ m)
Tbs na~e ott~ workconsim o~ (Chock One orDuon~ tho :Nm of Work)
~ boonnoo~onorn~~h'rephoeam~HeaztnsPhntmd/orA/C Condem=.
~ or new aL-cuR ~or replacemem ~eo~o Wu'dr Z-ba~er or power ven~cl
.___ New ~).~ for tM addl~ of A/C to sA b~m; Ml~ ~U (hous~ or the
tleo~Loil outlets.
I htroby veer,/tlab work v/dj be porfonne~ by an omployoe of r~is company and fur'dw verify
(i~int ~of Offlr, or) .....