HomeMy WebLinkAbout0102665-HVAC (a/c)OSHKOSH
ON THE WATER
.lob Address 3445 EICHSTADT RD
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 FOX CITIES CONSTRUCTION
Category 501 - Residential-Air Conditioning
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss IO As Approved
BTU Rate IO As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102665
07/07/2003
Other
Vent J
Use/Nature SFR/Install 24m btu A/C.
of Work
Fees: Valuation
Issued By:
$1,300.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$24.50
Date 07/07/2003
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
HVAC PERMIT APPLICATJO~,~_=~ ~'~J
All im'ormation after bold categories must bekl~j~l~./ ffFi~FA!
Incomplete applicatiom will not be proee~ c/~//~,~ ~.~./V]'/'lt'
· Application(s) and fee(s) can be brought to CiV/Hall, Room 205 or mailed to Inspection Servi6~ox 1128,
Oshkosh WI 54903-1128, Commencing work without p~m,lt(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
l£vou are a contractor varticivattn~ in the ~ermit £ee Account System and have adeauate £unds. check here
if ~ou want this vroce$$ed through your account [-]
CONTRACTOR MCM ATR, INC. 6122 COUNTY RD 51, WTNNECONNE~
CKECK [] ti,I, APPLICABLE
582-4402
WI 54986
FAX 582-0136
USE CATEGORY
t~kSingle Family nDuplex
E]Multi-Family ClRental
rlCommt~ial
OIndustrial
FUEL ~Oas [3Electric OSolid SYSTEM EINew c~Re~ ~.e
mOil tlSolar
TYPE
tlForcedAir I-IRadiant nsteam ]~A/C nVent tlElectric I-1HotWater I-ISuppl. tlCon. Bumer
IS CmMNEY BEING LINED l~No EYes - LINER SI~
Note: All chimneys shall be sized per the BTU's being vetoed.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
nChimney A
l~lAs Approved
~As Per Plan
tlChimncy B
tlExisting '
tlVariable
tlDir~t Vent
r'lNot Applicable
tlOther Value
DESCRI%FI~I~ON OF ALI. WORK BEING DONE
& IvlANU~A~
tlomer \o ~' 0..
VALUE (Including labor and all materials including light fixture) ~ '~ 5 ~ 0 --
L .C C CO CTo L
~ For applicable projecm, an Eleclric Installation Verification form, siBned by the Electrical ConWactor, mus~ be
attached. If not attached or not applicable, a separate F. le¢lrical P~mk is required.
9/02