HomeMy WebLinkAbout0101885-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 3733 PARKVlEW CT
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 SHAWN R/LISA M CAMPBELL
Category 501 - Residential-Air Conditioning
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
101885
06/02/2003
Other J
Vent J
Use/Nature SFR/Install 24m btu A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$1,500.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$27.50
Date 06/02/2003
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
R C VED
JUN 0 2 2005
HVAC
Incomplete applications will not be processed.
Application(s) and fee(s) can be Nought to City Hall, Room 205 or mailed to Insl~ction S~vices, PO Box 1128,
Oshkosh WI 54903-1128; Commencing work without permit(s) will r~sult in fees being doubled or $100.00 plm the
normal permit fee, which ever is greater.
OR
If you are a contractor varticipatin~ in the 'Permit fee dccount System and have adeauate.f~nd$, check here
if you want this ~rocessed through your account r']
JOB ADDRESS 3 7
CONTRACTOR MCM AIR. INC. 6122
CgPF. CK [] ALL APPLICABLE
DATE
COUNTY 'RD M, WZNNECONNE, WI 54986
'., 582-4402 FAX 582-013.6
USE CATEGORY
~ingl¢ Family I-IDuplcx
I-IMulti-Family
rlRental EiCommcrcial D l. ndttstrial
FUEL l~Gas [3Electric [3Solid SYSTEM l~l~v EIReplace
[3Oil [3Solar rlOther ". -
TYPE
ElForced Air r-lRadiant [3Steam [~A/C F'lVent [3Electric r'lHot Water rISuppl, nCon. Burner
IS CI:[IMNEY BEING LINED 13-No I-lYes
Note: All chimneys shall bo sized p~r the BTU's being vented.
HEAT LOSS
BTU RATE
IZlChimncy A
[3As ApprOved
DAs Per Plan
- LINER SIZE
[3C'Mnmey B
ElExisting
[~v'ariablc
DESCRIPTION OF ALL WORK BEING DONE
& MANUFA~
I'lDir~t V~nt rlother~
r'lNot Applicable
[3Other Value
VALUE (Including labor and an materials including light fixtures) $ [ '~--(-~ O
}~.For applicable projects, an Electric Installation V~ification form, signed by the El~cal 'Contractor, mu~t 1~
attached. If not attached or not applicable, a ~parat~ El~trical Permit is required.
Jun 0~,0~ 08:4Sa Oshkosh InspectiOns 8~0-~3S~508~ p.~
POB~ lDO
Electric Installation Verification
(B~ectdcal Contractor Name)
(~s) (~) (Slate) (Zip Code)
~e ofp~ ~n~acted w)
(Ad.ss wh~ work ~ll b, p~om~)
The nature of file work consists off (.Check One or D_,~c__-_dbe the Nature of Work)
R. econnection or new ch'cdt for replacement Heating Plmt ~or ~C Con~.
~ec~on or n~ c~c~t for repl~em~ El~c Water He~ or pow~ v~ted
wat~ ~.
R~fion of~c Sc~cc Bn~ce C~I~ Memr Box, ~temtions m m~mcl~
~d li~gns fix~ duc to sidins / so~t ing~la~on. Nole: N~ S~i~
EnCee C~lcs will ~qdre a scram pe~t.
~o~fion or new circ~t for ~= r~lac~t of o~cr
~p~c~ /
N~ ~t for ~e ad~fion of~C ~o ~ i~ividual ~ell~g ~it ~o~ or [he
in~vi~ systems ~ a duplex or condo~nim), ~eludi~g mq~ s~ce
eleoffic~ outlet.
0~
Th~ value
I hereby verify this work will. be performed by an employee of this cmnpany and further redly
the recom,.oction / instl~lat5on wiU be done in compliance with manufacturer and Electric code
r~luiremems.
(Signaturefof Company Officer) ~t Name of Officer)
(Da:e)