HomeMy WebLinkAbout2003-HVAC (a/c) SHKOSH
ON THE WATER
.lob Address 2110 WALNUT 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 JEFFREY E/JEANN SCHLICHTING
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 ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102406
06/24/2003
Other J
Vent J
Use/Nature SFR/Install 24m btu A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$1,900.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$33.50
Date 06/24/2003
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
it~ of Od~koah
Div/sion of Impection Senr/ces
P.O. Box 1130
Oshkosh, WI 54903-I 130
Phone (920) 236-5050
Fax (920) 2365084
HVAC PERMIT APPLICATION
All information after bold categories mx,_,t be pro~iclccL
Incomplete applications w/Il not bc procc~ecL
· 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; Coronvmcing work without permit(s) will result in fees b~ing doubled or $100.00 plus the
nonml permit fee, which ever is greater.
OR
If you are a contractor varticivatine in the ~Vermit fee/lecount System and have adeauate funds, cheek hcr~
if you want this ~rocessed through your ac¢o~t N
· 582-4402. F~;~?~3..6. ~
[~ingl¢ Family ~Duplex [3Multi-Family I'qRental rICommercia1 ClIndustrial'r//:~'
FUEL lNG-as ElElectric [3Solid ' SYSTEM EINew [3Replace
[30il [3Solar I~Other AC~c~ j~.f~. '~
TYPE
[3Forced Air [3Radiant [3Stem ]~,tC nv~nt [3Electxic
IS CIilIVlNEy BEING LINEDJ~No ~Yes - LINER SIZE.
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
OChirrmey A
OAs Approved
[3As Per Plan
[] Chimney B
[3Existing ·
[2Variable
[3Hot Water nSutrpl, nCon. Burner
& MA.NI~ACTURER
ClDircct V~t
[3Not Applicable
[30tber Valu~
mOther
DESCRIPTION OF AL,, WORK BEING DONE '~T~ ,%-Yeti / ~-~ h ~.~
VALUE (Including labor and aH materials including light fixtures) $ l C~ (~ 0
~For applicable ~rojects, an ~lectric lastalhtio~ Verification form, signed by the Eleeacal Contractor, must
attached. If not attached or not applicable, a separate Electrical F~,.,it is required.
9/02
Electric Installation ~erlficaflon
The nature of the work consists of.' (.Check One or Descn'be the Na~ur~ of Work)
Reoon~eetton or now clmuit for replacement He~ing Plmt ~d/or A/C Conden~r.
Rr, conneolion or new circuit for replacement V-lectric Water Hea~er or power vented
Recennec, fion of thc Scr~i~ F~.nce C.~le, Meter Box, alterations to receptacles
s=d lightins fixtures due to siding / soffit invalidation. Note: New Service
lhtra~ce Cables will require a s~l~ra~o pem~it.
3.econ~ec~on or new circuit for the replacement of other permanently wired
· X applianccs / f~or~.
individual systems in a duplex or co~lominium), includin..g required -~ervice
eleetrioal outlets.
Tho value of this work is $~
I hereby verify this work will. be performed by an employee of this cc~npau¥ and further verify
the .r~.~ctio~ / installation will be done ' ·
- in compliance with m~u~cmrer ~nd Blecmc code
(~'i~ure~of Company Officer)