HomeMy WebLinkAbout0102238-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 1307 WESTERN 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 SHARON A MUELLER
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
102238
06/17/2003
Other
Vent J
Use/Nature SFR/Install 24m btu @ ton A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$2,000.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$35.00
Date 06/17/2003
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 Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
City of Os~os~ ~V~ ~ ~.~
JUN 1 7
/ DEP RT ENT
HVA PERMIT DEVELOP ENT
~ ~o~don ~cr ~ld catcgo~es ~t ~ p~d~
~co~]c~ aPplicaQo~ ~ not ~ pr~
· Application(s) and fee(s) can be brought to City Hall, Room 205 or marled 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
i uw ' r ·
JOB ADDRESS
CO m ACTOa
CI~.CK I~ ALL APPLICABLE
USE CATEGORY
[~Single Family
COUNTY 'RD M,
I-IDuplex I-IMulti-Family I-1Rontal
WINNEC. ONNE, WI 54986
582.,4402 FAX 582-013.6
l-lCommercial E]Industrial
FUEL ~OilS ClElcctric BSolid SYSTEM
ClSolar
TYPE
BForced Air BRadiant BSteam J~dC r'lVent
I'lElcctric BHotWater BSuppl. B-ICon. Burner
IS CHIMNEY BEING LINED [llNo BYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFA~
CHIMNEY TYPE BChimney A . BChirr~ey B BDh-eet vent BOther
HEAT LOSS BAs Approved [~xisting BNot Applicable
BTU RATE BAs Per Plan ~Variable BOther Value
VALUE (Including labor and all materials includin: Ii:bt fixtures) $ }'~'0 (~) 0
]gl.For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
Electric Installation Verification
('F.,Lec'tri¢~ Contrector Nem~3
(A44~,) ' (City) (S~,~,) (Z.~p Code)
have b~en contracted to perform electric installation work {'or ~,
('Name of part3r c~ntracted w)
(dd~{ w~ ~o~k ~ bo p~:~)
The nature of the work consists of: (,Check One or Describe thc Nature of%'ork)
Reconneotion or new circuit for replacement He'n8 Plant and/or A/C Conden~r.
~~on or ~ ~t for ~l~t ~o W~r H~ or ~w~ v~ted
nd ~g ~ duc to si~ / w~t ~on. Note: Nm S~
~p~ / ~.
The value of this work is S~.
I hefty'verify tiffs work will. be performed by an employee of this company and further verify
th~ te, co~.,t~tion / installation will be done in compl/anee with manv.,fitcturer and Electric code
(S-i/rotate of Company O~cer) (Print Name of Officer) (Da~e)