HomeMy WebLinkAboutState Plumbing 1423275
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Safety and Buildings
1340 E GREEN BAY ST STE 300
SHAWANO WI 54166
TOO #: (608) 264.8777
www.commerce.wi.gov/sb/
www.wisconsin.gov
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AUG 23 2007
DEPARTMENT OF
COf'v1MUNlTY DEVELOPMENT
INSPECTION SERVICES DIVISION
Jim Doyle, Governor
Mary P. Burke, Secretary
August 21,2007
CUST ID No. 833765
ATTN.' Plumbing Inspector
JAMES EL VING
HORTY EL VING & ASSOCIATES INC
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505 EAST GRANT STREET .
MINNEAPOLIS MN 55404-1490
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MUNICIPAL CLERK
CITY OF OSHKOSH
PO BOX 1130
OSHKOSH WI 54903-1130
CONDITIONAL APPROVAL
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PLAN APPROVAL EXPIRE$: 08/21/2009
Identification Numbers
Transaction ID No. 1423275
Site ID No. 507121
Ple,l,tse ,refer to b()th identificatlonnUllllJets"
above;inillcorres ondeil(;eWith the aenc.
SITE:
Parkview Health Center
725 ButIerAve
City of Oshkosh, 54895
; Fire Dept ID: 7003
FOR: ,
Tenant Natne or Addn/ AIt :pescription: PARK VIEW HEALTH CENTER
Revision; Plan Type: New; 80 Exterior Fixture(s)
~. Object Type: Cross Connection Control Device, Health Care Regulated Object ID No.: 1146228
Revision; Device is Serving: Juice Machine; Device Type: Back Siphonage Breaker; Location on Property: RM IE 156,
So Wall- Juice Mch; Manufacturer: WATTS; Model: OD8PCQT; 1/2" Valve Size
'" Facility: 116569 PARKVI~W HEALTH CENTER
725 BUTLER AVE
WINNEBAGO 54985
" Tenant Name or Addn/ AIt Description: PARK VIEW HEALTH CENTER
Revision; Plan Type: New;: 1 Garage Catch Basin(s); 1 Grease Interceptor(s); 725 Interior Fixture(s)'
\ Tenant Name or Addn/ AIt Description: PARK VIEW HEALTH CENTER
Object Type: Interior Water Distribution System Regulated Object ID No.: 1099068
Revision '
\ Object Type: Cross Connection Control Device, Health Care Regulated Object ill No.: 1143485
Revision; Device is Servinl JUICE MACHINE; Device Type: BackSiphonage Breaker; Location on Property: ROOM
1A133 EAST WALL; Manufacturer: WATTS; Model: 008PCQT; 1/2" Valve Size
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, Object Type: Cross Connection Control Device, Health Care Regulated Object ill No.: 1143486
Revision; Device is Serving: JUICE MACHINE; Device Type: Back Siphonage Breaker; Location on Property: ROOM
1A170 EAST WALt; Manufacturer: WATTS; Model: 008PCQT; 1/2" Valve Size
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, Object Type: Cross Connection Control Device, Health Care Regulated Object ill No.: 1143487
. Revision; Device is Serving: JUICE MACHINE; Device Type: Back Siphonage Breaker; Location on Property: ROOM
1B 133 WEST WALL; Manufacturer: WATTS; Model: 008PCQT; 1/2" Valve Size .
" Object Type: Cross Connection Control Device, Health Care Regulated Object ill No.: 1143488
Revision; Device is Serving: JUICE MACHINE; Device Type: Back Siphonage Breaker; Location on Property: ROOM
IB170 WEST WALL; M8.1]1ufacturer: WATTS; Model: 008PCQT; 1!2" Valve Size
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2
8/21/2007
on ROOM
WATTS; 'Model:
No.; ll43490
Breaker; on
Siu
ROOM
...
ill No.: 1
on ROOM
on ROOM
Valve Size
on ROOM
ouPropCl'tji: ROOM
on
ill No.: 1143496
Location on
ROOM
on
ROOM
Device, Care
JlJ1CEMACHiNE; Device Type:
Model: 003]'CQT;
ROOM
on
ROOM
Device, Health Care
MACHINE; Device
Model:
Object ill No.:
Breaker;
Valve Size ·
on
ROOM
~
or
Interior
ill No,; 1146230
o\vner, tlSin
No person may
s.145.l:Ju, stiltS.
In or
at plumbing in the state unless licensed' ta do So by the Departmen tper
'.
1"*3
8r2.~ /2007
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construction 0,1"
to
or use:
Key Item(s)
,. 82.40(3)(0).
or a structure is served by a more tfum 000 water
m ~~ p~
PVB and
,.
a
.
so
the
not
Qf removed
.
.
and open to
All
should
this review
number
on
Fee
Fee ;$
Balance Due $ (lJ)(l