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Home My WebLink About0117448 B e OSHKOSH ON THE WATER Job Address 700 N WESTHAVEN DR CITY OF OSHKOSH No 117448 BUILDING PERMIT - APPLICATION AND RECORD Owner WESTHAVEN OFFICES LLC Create Date 12/01/2005 Designer Contractor AHERN FIRE PROTECTION Category 223 - Alteration Offices, Banks, Professional Plan Q7-95-1005 Type . Building 0 Sign 0 Canopy 0 Fence 0 Raze Zoning Class of Const: Size Unfinished/Basement -----2 Sq. Ft. -----2 Sq. Ft. Rooms Height 0 Ft. 0 Projection I Finished/Living Bedrooms Stories Canopies 0 Garage -----2 Sq. Ft. Baths 0 Signs -----2 Foundation . Poured Concrete 0 Floating Slab 0 Concrete Block 0 Post 0 Pier 0 Treated Wood 0 Other Occupancy Permit Not Required Flood Plain No Height Permit Not Required Park Dedication Not Required # Dwelling Units 0 # Structures 0 Use/Nature OFFICE / Modification of fire sprinkler system as per plan of Work HVAC Contractor Plumbing Contractor Electric Contractor $6,800.00 Plan Approval $0.00 Permit Fee Paid $56.00 Park Dedication $0.00 Fees: Valuation Issued By: Date 12/01/2005 Final/O.P. 00/00/0000 D Permit Voided I Parcelld # 1621650100 In the performance of this work I agree to perform ali work pursuant to rules goveming 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 201 Morris Court Agent/Owner Fond du Lac WI 54936 - 0000 Telephone Number 920-921-9020 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 perfonmed within two business days from the time the project is ready. Building Permit Work Card Job Address 700 N WESTHAVEN DR Permit Number 0117448 Create Date 12/1/05 Owner WESTHAVEN OFFICES LLC Contractor AHERN FIRE PROTECTION Category 223 - Alteration Offices, Banks, Professional Type. Building Zoning 0 Sign 0 Canopy 0 Fence 0 Raze Plan Q7-95-1005 Class of Const: Size Value $6,800.00 Stories Foundation. Poured Concrete 0 Concrete Block Height -----2 Ft. 0 Floating Slab 0 Post 0 Sq. Ft. Garage 0 Sq.Ft. -----2 n Projection I Canopies 0 Signs Unfinished/Basement 0 Sq. Finished/Living -Ft. Rooms a Bedrooms' a Baths 0 Pier 0 Treated Wood 0 Other Occupany Permit Not Required Flood Plain No Height Permit Not Required Park Dedication Not Required # Dwelling Units 2-- # Structures 0 Use/Nature OFFICE / Modification of fire sprinkler system as per plan of Work HVAC Contr Plumbing Contr Electric Contr Inspections: Date --'- Type Inspector DatelTime requested: Access: Notice Type: Phone Number: Ready DatelTime: ---'---- Requested By: 0 Reinspect Fee 0 Fee Waived D Reinspect Fee Paid ------------- --------------------------- ----------------------------------------------------- Page 1 of 1 ~ Ahern Fire Protection A division of J. F. Ahern Co. 201 Morris Court, P.O. Box 1316' Fond du Lac, WI 5493B-131B TEL (920) 921-9020 . FAX (920) 921-8BBB . www.ahemfi,e.com Wisconsin' Illinois' Missouoi . Neb..,ka. Iowa. Minnesota REC E lYE D JAN 2 52006 DEPARTMENT OF COMMUNflJY D:E!l.ELO¡PMfHf January 24, 2006 Building Inspector -- Brian Noe City of Oshkosh 215 Church Avenue -- PO Box 1130 Oshkosh, WI 54901 T -920/236-5051 F-920/236-1130 RE: FIRE PROTECTION SYSTEM INSTALLATION AURORA CLINIC FIRST FLOOR 700 ~~ÐRTHWESTHAVENDRIVE OSHKOSH, WISCONSIN 54904 AHERN FIRE PROTECTION PROJECT No. 991697 Dear Brian: Enclosed is a copy of the Contractor's Material and Test Certificates covering the above-referenced Fire Protection System Installation for your files. Very truly yours, AHERN FIRE PROTECTION Adivision of J. F. Ahern Co. ~ Batt~ Service Superintendent JRB/ksj LCITYOl'21'D6.00C' An Equal Opportunity Employer AHERN FIRE PROTECTION Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and teots shall be made by the conhaclors oepteoientative and wünessed by an owner's ,epresentative. All defects shall be concected and system left in service befo'e contractors personnel finally leave the job. A certificate shan be filled out and signed by both representati""". Copies shall be poepared lor approving authomK!s, owners, and contractor. It is understood the owoer's representative's signatuoe in no way p,ejudices any claim against contoacto, fo, faulty material, poor workmanship, or failu'e to comply wüh appmving authoritv's '"",u;rements or local ordinances. PROPERTY NAME Aurora Clinic AFP W.O. #: 991697 I DATE: November 14, 2005 PROPERTY ADDRESS 700 Westhaven Street Oshkosh, WI 54901 ACCEPTED BY APPROVING AUTHORITIES (NAMES) 1. Oshkosh Fire Department (Battalion Chief -- Stu Schrottky) 2. City of Oshkosh (Building Inspector -- Brian Noe) 3. 4. ADDRESS Plans 1. 101 Court Street -- Oshkosh, WI 54901 2. 215 Church Avenue - PO Box 1130 - Oshkosh, WI 5490.1 3. 4. INSTALLATION CONFORMS TO ACCEPTED PLANS DYES DNO EQUIPMENT USED IS APPROVED DYES DNO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN.CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION DYES DNO OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? INSTRUCTIONS IF NO; EXPLAIN HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: Item NÙ2 & 3"" ,. SYSTEM COMPONENTS INSTRUCTION DYES DNO be foowaoded by AFP 2. CARE AND MAINTENANCE INSTRUCTIONS DYES DNO atclœeo<rttime. 3. NFPA 25 DYES DNO LOCATION OF SUPPLIES BUILDINGS SYSTEM First Floor Remodel MAKE MODEL YEAR OF K- QUANTITY TEMPERATURE MANUFACTURE FACTOR RATING Vikino Microlast OR \IK3O2 Pendent 112" Chrome 2005 5.6 33 155 Dea. Vikina Mia_st OR VK3OO Uoriaht 112" Brass 2005 5.6 25 200 Deo. SPRINKLERS PIPE AND TYPE OF PIPE Liahtwall Non-Threadable' Thinwall Threadable FITTINGS TYPE OF FITTINGS Threaded' Mechanical Tees FLOW ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST CONNECTION TYPE MAKE MODEL MIN. SEC. Existing I T I N/A I T I EXPLAIN ANY ALARM PROBLEMS: ALARM DEVICES LOW AIR ALARM DEVICE ALARM OPERATED TYPE MAKE MODEL PRESSURE PROPERLY N/A I I SETTING PSI I YES NO I EXPLAIN ANY ALARM PROBLEMS: ",,:¡ i .. Ä~¡;~i=~~ :Pr~i~~fign CENTRAL MONITORING SIGNALS RECEIVED ALARM SERVICE LOCATION(S) TYPE OR PRESSURE '. NAME OF REMOTE WATERFLOW SWITCH LOW-AIR OTHER SERVICE DETECTQR FLOW SUPERVISORY SUPERVISING LOCATION(S): STATION (ON-5ITE) .. REMOTE REMOTE NAME OF SERVICE: MONITORING ALARM SERVICE SIGNALING (OFF-SITE) PHONE: OTHER: LOCATION(S): EXPLAIN ANY ALARM SIGNALING PROBLEMS: DRY VALVE I Q.O.D. MAKE MODEL I SERIAL NO. I MAKE MODEL SERIAL NO. I I I I I TIME TO TRIP WATER TRIP POINT AIR TIME WATER ALARM THROUGH TEST AIR PRESSURE REACHED TEST OPERATED CONNECTION'" PRESSURE PRESSURE OUTLET'" PROPERLY DRY PIPE MIN. SEC. PSI. PSI PSI MIN. SEC. YES NO OPERATING WITHOUT I I I TEST 0.0.0. Wffii I I I O.O.D. IF NO, EXPLAI~: OPERATION: 0 PNEUMATIC 0 ELECTRIC 0 HYDRAULIC PIPING SUPERVISED DYES DNO I DETECTING MEDIA SUPERVISED DYES DNO DOES VALVE OPERATE FROM THE. MANUAL TRIP, REMOTE, OR BOTH CONTROL STATIONS DYES DNO IS THERE AN ACCESSIBLE FACILITY IN EACH IFNO, EXPLAIN DELUGE & CIRCUIT FOR TESTING PREACTION DYES DNO VALVES DOES EACH CIRCUIT DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE SUPERVISION OPERATE VALVE RELEASE OPERATE RELEASE MAKE MODEL LOSS ALARM YES I NO YES NO MIN. SEC. I LOCATION & MAKE & MODEL SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE PRESSURE FLOOR (FLOWING) REDUCING I~t~i I O~pT~T l~pLET I °Y:~~T ;~~~ VALVE TEST PSI PSI PSI) PSI I I , MEASURED FROM TIME INSPECTORS TEST CONNECTION IS OPENED. 'NFPA 13 ONLY REOUIRES THE 6O-SECONO liMITATION IN SPECIFIC SECTIONS. 2 Ahem Fire Protection TEST DESCRIPTION HYDROSTATIC, Hydrostatic tes!$ shall be made at not less than 200 psi (13.6 bolS) for two houlS or 50 psi (3.4 bolS) above slatic pressure in excess of 150 psi (10.2 bass) for two houlS. Differential dry-pipe valve clappelS shall be left open during test to p",vent damage. All abovegroundpipingleakageshailbesioppOd.' .' "'. PNEUMATIC, Establish 4O-psi (2.7 bolS) air pressure and measure drop, which shall notexœed 1-1/2 psi (0.1 bolS) in 24 hoolS. Tesl pressure tanks at nonnalwaterlevel and air pressure and measure air pressu", drop, which shall notexœed 1-112 psi (0.1 bolS) in 24 houlS. ALL PIPING HYDROSTATICALLY TESTED AT ~PSIL-Bar)for --2....HRS. DRY PIPING PNEUMATICALLY TESTED DYES DNO EQUIPMENT OPERATES PROPERLY 0 YES 0 NO DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OR SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? YES DNO DRAIN READING OF GAUGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST TEST SUPPLY TEST CONNECTION:- PSI <-Bar) CONNECTION OPEN WIDE: - PSI LBar) UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISER OTHER EXPLAIN FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. TESTS VERIFIED BY COpy OF THE CONTRACTOR'S MATERIAL AND TEST CERTIFICATE FOR UNDERGROUND PIPING. 0 YES 0 NO FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING 0 YES 0 NO IF POWDER-DRIVEN FASTENERS ARE USED IN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? DYESDNO BLANK TESTING GASKETS NO LOCATIONS IF YES... WELDING DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS B2.1? DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS B2.1? DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO ENSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? SIGNATURES DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: NAME OF SPRINKLER CONTRACTOR AHERN FIRE PROTECTION, 201 MORRIS COURT - FOND DU LAC, WI 54935 TESTS WITNESSED BY TITLE ¡:¡ ADDITIONAL ~XP ATIONAND NOTES: f I. t.;. 6;; 1:., c $?~ () J.fI-¡ä¡;¡¡ f { Itt j)e.py-, 1-IZ,of, 3 IF NO, STATE REASON IF NO, EXPLAIN NUMBER REMOVED DYES DNO DYES DNO DYES DNO YES DNO IF NO, EXPLAIN ,~ l 'Z.-O DATE