HomeMy WebLinkAbout0115100-Plumbing (sink in GK 185; showers)
e CITY OF OSHKOSH No 115100
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 07/05/2005
Contractor BASSETT MECHANICAL Category 440 - Industrial-Interior Plan
Bathtub 0 Shower 0 Water Softner 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
- - - - - -
Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
- - - - - -
Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 1 Catch Basin 0 Ext Grease Trap 0
- - - - -
Toilet 0 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
- - - - - -
Res. Sink 0 Dishwasher 0 Beer Tap 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
- - - - - -
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
- - - - - -
Water Heater 0 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Deduct Meters 0
- - - - - -
Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0
- - - -
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
-
Misc. 3
Fixtures
Use/Nature
of Work
Plumbing fixture addition sink in room GK 185 and two emergency decontamination showers.
Size
Material
Type
#
Conn. Type
Sanitary Sewer
0
0
0
0
0
Storm Sewer
0
0
0
0
0
Water Service
0
0
0
0
0
Parcelld #
0613660000
$28.00 U Permit Voided I
Valuation
$6,000.00
Plan Approval
$0.00
Permit Fees
Issued By
Date 07/08/2005
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
Address
PO BOX 7000
Agent/Owner
KAUKAUNA
WI 54130 - 7000
Telephone Number
800-236-2502==920-~
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.
./1 commerce.wi.goy
~ !!~9J}!J!!
Safety and Buildings
2331 SAN LUIS PL STE 150
GREEN BAY WI 54304
TOO #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisccnsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
June 29, 2005
CUST!D No.232819
MARK A HUTTING
BASSETT MECHANICAL
1215 HYLAND AVE
PO BOX 7000
KAUKAUNA WI 54130
ATTN: Plumbing Inspector
BUILDING INSPECTION
CITY OF OSHKOSH
POB 1130
OSHKOSH WI 54902
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/29/2007
SITE:
Mercy Medical Center
500 S Oakwood Rd
City of Oshkosh, 54904-7944
; Fire Dept !D: 7005
FOR:
Facility: 665006 MERCY MEDICAL CENTER ROOM GK 185 500 S OAKWOOD RD OSHKOSH 54904
Object Type: Plumbing System, Building Specific Regulated Object!D No.: 1024976
Hospital, Nursing Home, or Ambulatory Surgical Center; Plan Type: Addition-Alteratio ; I Interior Fixture(s)
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The own r, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirem ts.
A copy of the approved plans, specifications and this letter shall be on-site during constructio and open to
inspection by authorized representatives of the Department, which may include local inspecto s. If plan index sheets
were submitted in lieu of additional full plansets, a copy of this approval letter and index shee shall be attached to
plans that correspond with the copy on file with the Department. All permits required by the s te or the local
municipality shall be obtained prior to commencement of construction/installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require chan es or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), no . g in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or comp nent.
Inquiries concerning this correspondence may be made to me at the telephone number listed b low, or at the address
on this letterhead.
Sincerely,
Fee Required $
Fee Received $
Balance Due $
80.00
80.00
0.00
Wesley C Grnbe
Plumbing Plan Reviewer, Integrated Services
(920)492-5613 , M-r 7:00 - 16:30, F 7:00 - 11:00
wgrnbe@commerce.state.wi.us
l65È.
cc: James E Zickert, Plumbing Consultant, (920) 948-7336
Tom Laabs, Affmity Health System