HomeMy WebLinkAboutCross Connection Control Assembly
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... j commerce.wi.gov
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Safety and Buildings
PO BOX 7162
MADISON WI 53707-7162
TDD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
August 23, 2007
CUST 10 No. 952430
I
I
DAVID MILLER
OMNI GLASS & PAINT
2010 DICKINSON AVE
OSHKOSH WI 54903
ANDREW 0 GROSS
A G MECHANICAL
1820 MARATHON AVE
NEENAH WI 54956
AUG 24 2007
DEPARTMENT Of:
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISIO
CROSS CONNECTION CONTROL ASSEMBLY
REGISTRATION
Identification Numbers
Transaction 10 No: 1433756
Site 10 No. 729537
Pleaseteferto both identification
numbers, abdve, in all correspondence
with th~ aaencv.
SITE:
Omni Glass & Paint
3530 Omni Dr
City of Oshkosh, 54904
FOR:
Object Type: Cross Connection Control Device Regulated Object 10 No.: 1148802
Device Type: Reduced Pressure Preventer; Location on Property: MECHANICAL ROOM; Manufacturer:
WATTS; Model: 009M3QT; Serial No.: A44044; 3/4" Valve Size
Per your request the device(s) described above has been REGISTERED with our agency, in lieu of plan
review by our agency. As owner of this building, you should understand:
1. That there will be no review of the installation plans for this project conducted by the Department of
Commerce.
2. That there will be no routine inspections conducted by the Department of Commerce during the
installation of this project.
3. . That plan review and/or inspections by the local municipality may be required by local permitting
ordinances.
4. That this registration does not affect the requirements to submit plans for building systems, plumbing
systems, private sewage systems, swimming pools, elevators or other plans if applicable.
5. That upon completion of construction, this installation shall be in compliance with all applicable
Wisconsin codes and standards.
6. That as the owner, you are responsible to assure that a performance test is conducted for the above
assemblies at the time of installation, immediately after repairs or alteration to the assembly and at
least annually.
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8. No person may engage in or work at plumbing in the state unless licensed to do so by the department
per s.145.06 stats.
Prior to the start of construction, all applicable plumbing permits should be obtained from the authorities
having jurisdiction in accordance with local laws and ordinances. This registration is valid for the period
indicated above. Thereafter, the unfinished portions of the project shall be redesigned to the code existing
at that time and shall be re-registered with our agency.
OMNI GLASS & PAINT
Page 2
8/23/2007
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at
the address on this letterhead. Please refer to the Transaction 10 No. referred to in the regarding line
when making an inquiry or submitting additional information.
Sincerely,
....
~
Christine Severson
Program Assistant, Integrated Services
(608)267-2497 , 7:30 To 16:00
christine.severson@wisconsin.gov
cc: Municipal Clerk City of Oshkosh, 920/236-5011
Fee Required $
Fee Received $
Balance Due $
WiSMART code: 7657
125.00
125.00
0.00