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Home My WebLink About0128282-Plumbing e OSHKOSH ON THE WATER Job Address 500 S OAKWOOD RD CITY OF OSHKOSH No 128282 PLUMBING PERMIT - APPLICATION AND RECORD Contractor BASSETT MECHANICAL Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures ~:~~~~ure iHosPital/lnterior alterations as described in th\'l ap-provedP1a-n~ InstaIIRP-valve"to supply water disintections"ysie-m-:--**check#22322f- Shower Water Softner Floor Drain Local Waste Lndry Tray Clothes Wshr Disposal Bidet Dishwasher Beer Tap Sump Pump Lab Sink Classrm Sink Sterilizer Breakrm Sink Dip Well Ejector/Grind Drink Ftn i l__ Owner MERCY MEDICAL CENTER OSH INC Create Date 12/07/2007 Category 440 - Industrial-Interior Plan Wait. St. Ice Chest Exam Sink Shamp Sink FlrlWst Sink Catch Basin Wash Ftn Coffee Maker Urinal Int Grease Trap Ext Grease Trap RPZ Valve Eye Wash Statn Wtr Sewer Mtrs Deduct Meters Sculry Sink Hand Sink Plaster Sink Surgeons Sink F Prep Sink Serv Sink Standp Rec Ice Maker Gar Drain Wtr Usage Mtrs Soda Disp Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcelld # 0613660000 Valuation ____11,-QQQ.00 Plan Approval _"__~__~Q"O'(} Permit Fees_____..J_25.OQ O~~~ll1i!_""?i~~d_j Issued By ~~ Date 12/27/2007 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 Agent/Owner Address Pg_E30X 7222___ _"____"I<.A._UI<AU~.A.__ ____.. \^JI 54139 - 7999__ Telephone Number 800~236-2502.==.==_~2Q~ To schedule inspections please call the Inspection Request line at 236-5128noting 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. . ..Jul I I I 22 04 10:02a Oshkosh Inspections 820-236-5084 p. 1 City of Oshkosh . '~Declion Services Division :~ :". i - 1)\')):. 1130 -'..". _ _-"osh. WI 54903 -1130 Phone: (920) 236-5050 Fa.\: (9.20) 236-5084 I ~ OfHKOfH or. r....= II/"r~~' . DEe 2 1 Z007 . DEPARTivlENT o~ COMMUNI1Y DEVELOP~IJENT I INSPECfION SERVICES DIVISIO\,\ Plumbing Permit Application I hereby apply for a pennillo do and install the following plumbing on the premises hereinafter described, the work to conform to the Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes. . Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the nomlal pennit fee, which ever is greater. OR If \'OU are a contractor Darticinat;1l1! ;n the Permit Fee Account Sl'stem and have adequate fund.~. check here if "ou want tlzis nrg~~s.s..edflzr...ou'Zh l/our account n Job Address 500 S. Oakwood Rd Value (Including I:!.bor And malcri:lIs) Date 12/20/0~_ Owner Mercy Medical Center Con tractor Bassett Mechanical DSingle Family XX HOSPITAL DDuplex DL\'lulti-Family DRental DCommercial Dlndustrial f\\nber of Fixtures: , ) Floor 1ff-lIn lndry Tr:lY Uib Sink Pl3sh:r Sink ~ lndry St:lntJp O.:nl.Orcr. Sh~mp Sink Dlsp-'sal DipWctl Flr!Wst Sink Dishwasher Drink FbI Calch U:l~in Sump Pump Wait.SI. \Va.d, FIll F.jcctor/<irind Ice Chest Unn.,l W:ll<:r Sollner I:lCamSmk (jar Or-din l.ocal Waste Scu1r)' Slflk So,l.. Oi ~p Clothcs \Vshr H:lnd Sink Coffee ".lakcr Didcl F Prep Sink Ice M:lkcr Beer T "p Sc:rv Sink Sile Or,lIn CI:!s.iml Sink Inl GrCo'lSC Tr:lp Rouf [)raln Surgeons Sink EXI Orc:!se Trnp SlOlndp RCI: Brealmn Sillk R.P.Z, Valllc ---L- Eye W:lsh SIn UJlhlub Whirlpool 1.:l\':Itor y To,kl Res. Slnl.: Oar Sink W:ller He:!.lcr t.: V:lS .:J Elect 0 r....TVnt Shower SlcrilizL'r Electric Contractor OR DElectric Installation Verification form attacbed (If RllJIbccment) Use I Nature of "'ork Size Material Type /# COM. Type Sanit3rj'SeWer /~)m Sewer Water Service 7/03 12/21/2007 14:11 FAX 920 759 2525 BASSETT MECHANICAL 141 002 State of Wisconsin Department of Commerce ~~~~ ~~~ Safety and Buildings Division P.O. Box 7302 Madison, WI 53707-7302 Telephone: (60B) 266-0521 Fax: (608) 267-0592 TTY: (608) 264-8777 Regulated Object Number Owner Information Owner Name Merc Medical Center City Oshkosh Pro"ect Information Project Name Merc Medical Center City Oshkosh WI Assembly Location Boiler Room east wall for clorine dioxide unit Manufacturer Wilkins Zurn Size 1h" State WI Zip Code 54904 Telephone Number Zip Code 54904 Street Address . 500 S. Oakwood Rd County Winneba 0 Assembly Type: [8] RP Model 975 XL D RP Detector 0 DC Serial Number W346227 o DC Detector D PVB/SVB INITIAL TEST 1slcheck ~ Closed tight o Leaked Static 8.2 PSID 2nd check ~ Closed tight o Leaked Static 2.5 RP relief valve Opened at 3.8 o Did not open PSID PSID FINAL TEST o Closed tight Static PSID o Closed tight Static Opened at PSID PSID DETECTOR BYPASS ASSEMBLY INITIAL TEST 1 sl check 2nd check o Closed tight 0 Closed tight o Leaked 0 Leaked Static PSID Static RP relief valve Opened at o Did not open PSID PSID DETECTOR BYPASS ASSEMBLY FINAL TEST o Closed tight 0 Closed tight Static PSID Static Opened at PSID PSID PRESSURE VACUUM BREAKER INITIAL TEST Air inlet valve Check valve Opened at PSID 0 Closed tight o Did not open 0 Leaked Static PRESSURE VACUUM BREAKER FINAL TEST Air inlet valve Check valve Opened at PSID 0 Closed tight Static PSID PSID ASSEMBLIES IN FIRE PROTECTION SYSTEMS Forward Flow Test Designed flow rate No. of nozzles flowed Inlet flow pressure Note: Include hose stream demand where applicable PSI Actual flow rate Nozzle size Outlet flow pressure GPM Static pressure Pilot pressure PSI PSI GPM PSI IndicatinQ Flow Test o No. one control valve open 0 No. two control valve open Valve supervision: 0 Tamper switch 0 Locked Part(s) Replaced/Comments I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED BY MY PERSONALLY. Tester Name (Print) Nick Grams Registration No. 694726 Time of Day 6:00 pm Tester Signature ~A ~~ Phone No. (920) 759-2500 Date 12/13/07 5BD-9927 (R8I98)