HomeMy WebLinkAbout0102642 HOSHKOSH
ON THE WATER
.lob Address 1286 W 18TH 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 SANDRA A CONGER
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA
Heat Loss I~ As Approved
BTU Rate I~ As Per Plan
Chimney B
~ Existing
~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
102642
05/30/2003
Other
Vent J
Use/Nature
of Work
Finishing area in basement for a bathroom (install 1 supply air run).
Fees: Valuation
Issued By:
$100.00 Plan Approval
$0.00 Permit Fee Paid
Permit Voided J
$20.00
Date 07/03/2003
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 APPLICATION
All information after bold categories m,s~ be provided.
Incomplete applications will not be proce~ed.
· Application(s) and fee(s) can bc brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128; Commencing work without permit(s) will re. suit in fees being doubled or $100.00 plus thc
normal permit fee, which cvcr is greater.
OR
If you are a contractor vartici~atin~ in the ~ermit tee ~Iccount System and have adeouate funds, check here
if you want this vrocessed throuirh your aceoung N
DATE
JoB .VDaESS
OWNER
CONTKACTOR MCM AIR, INC.
C~CK [] AI J. APPLICABLE
6122 COUNTY RD M, WINNECONNE, WI 54986
582-4402 FAX 582-0136
sE CATEGORY
ingle Family ClDuplcx ClMulti-Family ElRental r'lCommel~ial ~Industrial
FUEL ~G~s EiElectric EiSolid SYSTEM EiNew ClP,~place
~0
il I-ISolar EiOth~ ' '
TYPE
I-1Forced Air EiRadiant I-Isteam I-IA/C rlVent rlElcctric rlHot Water I-ISuppl. EICon. Burner
IS CHsnfNEY BEING LINED EINo I-IYes - LINER SIZE.
Note: All chimucys shall be sizcd per thc BTU's being vented.
&MANUFACIORER
CHIMNEY TYPE
HEATLOSS
BTU RATE
I~Chimney A
EIAs Approved
I-lAs per Plan
['~Chimney B
EiExiaing '
EiVariable
clDir~t Vent
EINot Applicable
EIOther Value
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all mafertals including light fixtures) ~; 1,00 °a'
ELECTRICAL CONTRACTOR
[3 For applicable projects, an Electric Installation Verification form, signed by the EleClrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical P~,,~it is required.