HomeMy WebLinkAbout0104757 HOSHKOSH
ON THE WATER
.lob Address 1010 W 19TH AVE
Contractor MCM AIR INC
Fuel [~J Gas ~
System ~ New
~ Forced Air 1
~J Electric I
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Radiant
Hot Water
Owner DAVID/KATHLEEN ZIEHM
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 ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
104757
10/13/2003
Other J
Vent J
Use/Nature SFR/Install 60m btu furnace and 1.5T 18m btu A/C. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$4,600.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$74.00
Date 10/13/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 6122 COUNTY ROAD M WINNECONNE WI 54986 -9780 Telephone Number
(920) 582-4402
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
~ of Osl~o~
Db~ion oflnspe~on Se~iees
P.O. Box 1130
~ ~ 54903-1130
Pkn~ (920) 236-$050
Fax (920) 236-5084
OCT
HVAC PERMIT APPLICATI( .AR-r rw
lncomplmapplicationswillnotb~~ r -VE£0P ENT
· Applicalion(s) and fee(s) can be brought to City Hall, Room 205 or mailed to hmpecllon Sorvi~, ~ ~x 1128,
Oshkosh WI 54903-1128. Commencing work without l~',,,R(s) will result in fee~ b~ng doubled or $100.00 plus the
noiw~l Introit fee, which ever is greater.
OR
If you are a contractor narticlvatin~ in the 'Permit fee Account System and have adca~4~tte funds, check here
tf ¥ou want this t~roeessed through your account ~l
I0 -
JOB ADDRESS ~[]A-U ~- ~ t~. ~ ~
CONTI~ACTOR MCM AIR, INC.
ut~CK [] ~x.x. A~?LICABLE
6122 COUNTY 'RD M, WINNECONNE, WI 54986
,, 582-4402 FAX 582-0136
USE CATEGORY
l~Sin~cFamily DDupl~ ~Mulfi~amily
I-IR~ntal ~'lCommorcial Olndustrial
FUEL ~1 OEleetric OSolid b~tSTF.,~ ClN~-w ~R~'place .
OSolar KIOtl~cr "',
TYPE
~or¢cdAir ORadiant OSt~am ~C IDVcnt OEl~tric
IS C~4 ~MNEY BEING LINED ~No I-Iycs . LINER S!~-
Note: All chimncys shall be sized per the BTU's being vented.
~Hot Wator OSu~l.
& MANUFACTURER.
OCom Bur~r
CHIMNEY TYPE
HEAT LOSS
BTU RATE
IDChimncy A
OAs Approvcd
OAs Per Plan
ClClfinmcy B F1Direct ¥~at ~Otl~r P'k/
~Exi~dng 12Not Applicable
~-IVariable I-IOth~ V~hie
D SCP. n-rio worn(
VALUE (Including labor and ~1
ELEcrKICAL CONi'RACTOR
~For applicable projects, an Elecwic Installation Vetifioalion form, silp~l by~ Eleetr~cal Contractor, must be
attached. If not attached or not applicable, a separate Eleetrioal Permit is required.
Electric l. nstalhtlon Verification