HomeMy WebLinkAbout0102471-HVAC (install a/c)OSHKOSH
ON THE WATER
.lob Address 902 SCHOOL AVE
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 JON A PETRI
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
102471
06/27/2003
Other J
Vent J
Use/Nature SFR/Install new 2 ton 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 06/27/2003
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 ,f o'hko.,h
. Divisic~ of Impection Services
p.O. ~x 1
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
· Applicator(s) ~ ~(s) ~ be ~o~t ~ Ci~ ~all, R~ 205 ~ ~ ~ ~~ 8~, ~O Box 1128,
O~
ff vou are a contractor ~artici~atin~ in the 'Permit fee ~ccount System and have adeauate funds, check h~rq
if you want this vrocessed through your accou~g ~
owNER.
CONTRA~OR MCM AIR, INC. 6122 COUNTY RD
C~CK [] ALL APPLICABLE
M, WINNECONNE, 'WI 54986
582-4402 FAX 582-013.6
E CATEGORY
ingle Family r'lDuplex ElMulti-Family C]Rental
r'lCommercial
C]Industrial
/
FUEL ragas EIElectric ElSolid SYSTEM
ElOil FlSolar
~or. ced Air ElRadiant OSteam C OVent ElElectric
IS CHIMNEY BEING LINED nNo OYes - LINER. SIZE.
Note: All chimneys shall be sizexi p~r the BTU's being vented.
ONew F ~ ~ ~-place
C]Hot Water OSuppl. nCon. Burner
& MANUFACrImER
CHIMNEY TYPE
Fl'EAT LOSS
BTU RATE
I-1Chinm~y A
OAs Approved
nAs Per Plan
OChimney B
r'lVariable
ElDirect Vent
ElNot Applicable
ClOther ValUe
ElOther
DESCRIPTION OF ALL WORK BEING DONE
. . crmcAL co n cro
KFor applicable ~oject% ~ £1ecU'i¢ Immll~tion V~ification form, ~igned by th~ Ele~trical'Conu-~tor, mu~t b~
attached. If not attached or not applicable, ~ ~-parat~ Electrical Permit i~ r~luir~d. '
9/02
p.2
Electric Installation Verification
~tectric~l Contractor Name)
(sa, e)
~e ofp~ ~n~d to)
~ ~ follo~ng ad.ss: ~0~' ~'~ OO ~ ~ ~
(M~sS w~ work ~ bo p~~)
tCeconneotion or new circuit for replacement Heatin& Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
Reconnection of thc Scrvice Eatranoe Cable., Meter Box, alterations to recep:acles
and lighting fixturcs due to siding / soffit installttion. Note: New Service
Entrance Cables will require a sep~a~ pctmiL
ICeco~ection or new circ~ for the replecement of other permencntly wired
appliances / fixtures.
New circuit for the additio~ of A/C to
individual systems in ~ duplex or condominium), including required service
eleotrical outlets, '
The value of this woz:k is S~.
I hereby veery this work will. be performed by au anployee of this company and ~er veri~y
the recx~.a~clion / installation will be done in compliance wkh manu~cturer arid Electric cxxle
(Signarure~of Company Officer) (Print Name of Offic=) "
?
r lzq to .