HomeMy WebLinkAboutHVAC 67-697H (6/3/1997)
Date 6/3/97
IL• Company Name
~- Address
H City/State/Zip
ON THE WATER
GARTMAN MECHANICAL
520 W SOUTH PARK
OSHKOSH WI 54901
Dear Mr. VERKUYLEN
Heating and Cooling Unit Replacement:
Address 145 70S3LYN
Oshkosh
Owners Name LOURDS ACADEMY-TERRA HOUSE
File # 67-697H
i
Your Heating-Cooling replacement letter and calculations have been reviewed for
compliance with important code requirements. Copies of the letter have been stamped
and are being returned to the owner. This approval is not a Heating Permit. Necessary
City permits must be obtained before commencing work.
The building will be inspected during construction and a final inspection will be made
after completion to insure complete compliance with City and State codes.
You are hereby advised that the owner,' as defined in Chapter 101.01(1) of the Wisconsin
State Statutes, is responsible for all code requirements not specifically cited herein. Code
requirements are set forth in Chapters 50 through 64 of the rules of the Department of
Industry, Labor and Human Relations. ~',
Sincerely,
j `'c2~~'
Lee A. Erdmann
H.V.A.C.Inspector
j
~- City of Oshkosh
P.O. BOX 1130
QfN~ OSHKOSH, WI 54902-1130
ON THE WATER
COMPANY NAME Ir~j ~ DATE 5~~1C~~
ADDRESS ~~ ~_
CITY/ STATE
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APPROVAL REQUIRMENTS FOR REPLACEMENT OF COMMERCIAL AND INDUSTRIAL HEATING
AND COOLING EQUIPMENT FOR BUILDINGS UNDER 100,000 CUBIC FEET
IN AREA
1 OWNER OF BUILDING
I
2) ADDRESS O BUILDING
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3) AT THE UI ING i .USED FOR
4) EQUIPMENT BEING REPLACED (MODEL,SiZE)
5~Nr~IV EQUIPMENT (MODC Ei.,\SIZ~ ,rn ; v '
`'mot ~~ Y ' l~'~O~,t-~-~
a~S,C~v ~ "ft-P
6) WAS THERE ADEQUATE HEATING8JOR~ COOLING? ~~ S
~ H~~ S THE NEW UNIT SIZED? -
8) IS THERE A BOILER/FURNACE ROOM?! v ,e J -
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HEATING 8 VENTILATION PLATS
REVIEWED BY CITY OF OSHKOSIi
fOR COMPLIANCE WITH REQUIREMENTS Of WISCONSIN
DEPT. Of INDUSTRY,1A80R AND HUMAN RELATIONS
SEE CORRESPONDENCE
9) PLEASE INCLUDE STATE FORM SBD118 WITH A $80.00 FEE.
BUILDING/STRUCTURE/HVAC PLANS APPROVAL APPLIUITION
w~uonsirroepartmentof Industry, -Complete Both Sides -
Labor e. Human Relations E-File
Safety +1 Buildings Division Schedulin Information - com lete / ..s-G,!'~~
Bureau of Buildings 8 Structures g p ~~!
vvhencalling to schedule review: Plan No. _
INSTRUCTIONS: Fill in all applicable data. Caution: Failure to complete the form entirely may cause additional delay
Submittal of this Plans Approval Application is required for each building. Submit this form with at least 4 sets of plan;
which include details and data as required by ILHR 50.12. Plans may be submitted to any of the plan review offices li r> ed
on the reverse side. Projects are scheduled for review. Please call the selected office prior to submittal. Any compon ~~ rts
submitted independently from the building plans must be submitted to the office which. did the project's initial revle~~-.
1. Owner Information
2. Project Information .,~
3. Building or Structure f~sign;
Information
Nam Building Occupancy Chapter(s) And Use: Designer Regis' ~ ~tion k
v pv/° /~Oa?c '
_Qmpany ame Tenant Name (if any) Design Firm
Number 8 Street Building Location (number8 street) Number & Street
/o s ~ ~~ sa o so rr~f PA~~
City, State, Zip ode City ^ Village ^ Township Of City, State, ZipCode
~/it Sy9v / 4 5 OSi~ G/~3' S'tr!!al
Contact Person County Of ! ~ Contact Person
o i>~~ if ~R?t i W i~
Telephone Number Property ID No.,(tax parcel no. -contact county) Telephone Number Fax Number
Fax Number Government Owned ^ Yes No Return Plans To: ^ Owner (Designer
( ) Government Leased Or Operated ^ Yes ~'No ^ Other
4. Building History S. Construction Class Requested 6. HVAC Designerlnformation
Previous Owner(s) (if any) ^ 1. Fire Resistive Type A Des'g er Registration
^ 2. Fire Resistive Type B ~
^ 3. Metal Frame -Protected _
~s~grt ir1m
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^ 4. Heavy Timber l
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Previous P an or Fi a No. ^ SA. Exterior Masonry -Protected Number 8 Street
^ 58. Exterior Masonry -Unprotected 5'~ w-
variance No. , Pre im~nary No. ^ 6. Metalframe -Unprotected late, rp e
^ 7. Wood Frame -Protected w~
Other Information (previous use, Isst wbmission) ^ 8. Wood Frame -Unprotected n Pers n
If plansdo not show compliance with requested U a
Construction class but are approvable at a lower
clan, do you wishapproval atthe lower dasst
Telep one Number F x umber `
~
^ Yes ^ No - SS3O
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7. Building Information 8. Submittal Request 9. Supervising Professional lnforfnation
^ Complete Sprinkler -NFPA Froiect ~ Review Requested ^ For Building ~ Same As Building nes~gner
^ Partial Sprinkler -NFPA
li
it
U
d A ^ New ~ ^footinglFOUndation
^ Ak
ti
B
ildi
For HVAC ,Same As HVAC Designer
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m
rea
^
e era
on ^
ng
u
Supervising Pro i i event ro~~-gner
^ Fire Alarm ^ Emergency Power ^ Addition ^ Permission To
^ Smoke
Detection ^ Haz
rd Enclosure ^ Revisions ' Start
.
a RegistratOn /~
Q Use Change ! 'HVAC
^ILHR 70 Hist Code ^ Truss
Total Number of Stories . Num r & treet
Building footprint Area sq ft ^ Variance ^ Precast
^ Preliminary ~
^ Structural
Soil Bearing Capacit f
y ~ ,
^ Canopy ^ Laminated Wood City, tale, Zip e
^ Presumed ^ Bleacher ~ ^ Metal Building
^ Verified ^ Tower ^ Joist/Girder a ep one um r
^ Other
t0. Related Business Systems -Please call the respective Program for clarification and plan submittal requirements.
~, ,
^ Elevators(608-267-3576)includes:
^ Passenger elevator meeting ILHR 18 req.
^ Freight elevator meeting ILHR 18 req.
' ^ Part 5 lift (residential type)
^ Part 20 lift (wheelchair lift)
SeD-118 (R. 12/92)
FlammableKombustible Liquid (608-267-1379)
Will any portion of this building be used for
storage or dispensing of flammable
combustible liquids as covered by ILHR t Oi
^ Yes ^ No
^ Boiler/Pressure Vessel (608-266-1904)
^ Mechanical Refrigeration/AC (608) 266-1904
^ Plumbing (608-266-3815)
Sewer.
^ Municipal ^ Private Sewage System
fy
11. Calculation of Fees
Area: The area of a floor is the area bounded by the exterior surface of the building walls or_the outside face~of
columns where there is no wall. Area includes all floor levels such as subbasements, basements, ground
floors, mezzanines, balconies, lofts, all stories and all roofed areas including porches and garages, except fer
cantilevered canopies on the building wall. Use the roof area for free standing canopies.. Total area is the
summation of all floor areas. ~ ,
Attech a separate sheet if necessary for the calculations below:
Floor Level (specify) Length X Width Area
X e
X
X
X
X =
j ota Area =
^ Project NOT located in certified municipality (go to Fee Schedule Table 2.31-1).
^ Project located in certified municipality (go to, Fee Schedule Table 2.31-2).
(See Fee Schedule for list of certified municipalities.)
^ Building and HVAC .................. ~ ... ................... .. Fee S
^ Building Only ........ ............. ............................ Fee S
^ HVACOnIy ...............:.......... ............................
Revision To Previously Approved Plan ... i~ ....... .................... Fee
Fee S ~ja, ao
S
^ Permission To Start .................. ............................ Fee S
^ Pre-July 1992 Building Components .... ~~~~ ........................... . Fee S
^ Other I ......... ........ .. Fee S
Total Fee. _ S . o 0
12. OWNER'S STATEMENT pLHR 50.11): I request that plans be reviewed for compliance with the code requirements set
forth in Chapters ILHR 50.64 of the rules of the department. I recognise that I am responsible for compliance with
all code regtarements and any conditions of Plan approval. If this building exceeds 50,000 cubic feet in total volume, l
will retain a-supervising professional as requtred by ILHR 50. tOthroughout construction to project completion and the
filing of a Completion Statement by the supervising professional.
Owner's Signature: ~ ~ Name & Title ~Q~N /~/~?c~
Orig nal ! Print
t 3. DESIGNER'S STATEMENT: DESIGN (ILHR 50.07-50.09) if this building, following construction of this project, contains
more than 50,000 cubic feet in total volume, plans are required to be prepared, signed, sealed and dated by a
Wisconsin registered engineer or architect (ILHR 50.07(2)). Signatures and seals shall be original
The department expects, and requires, that the pproject designer review individual component submittals for
compliance with the general design concept. Theproject designer, and department, will rely on the seal of the
component designers for compliance with the codes as they apply to their designs.
Total cubic foot volume of the building upon completion of this project: ^ Less Than 50,000 ^ 50,000 or Greater
Design loads have been indicated on the clans. .................................... ....... ^ Yes ^ N/A
Firewall schematic planhas been included . ... ............................................. ^ Yes ^ N/A
All applicable items required by ILHR 50.12 have been included . ............................... ^ Yes ^ N/A
I certify that the submitted plans were prepared under my supervision, are accurate, and to the best of my knowledge
comply with the applicable codes of the Department of Industry, Labor and Human Relations.
Ongma
~~
Ono+na
riginal Signature of HVAC Designer
14. SUPERVISING PROFESSIONAL'S STATEMENT:- (ILHR 50.10) I have been retained by the owner as the supervising
professional per ILHR 50. t0 fcr the performance or supervision ofreasonable on-the-site observations to determine if
the construction is in substantial compliance with the approved plans and specifications... Upon completion of
construction, l will file a written statement with the department certifying that, to the best of my knowledge and
belief, construction has or has not been performed insubstantial compliance with the approved plans and
specifications.
Original ignature o Pro essiona Supervising T e Bui ing Date igne rigma ignature o Pro ess~ona upervtsinp a HVA Date igne
Hayward Of'~ce La Crosse Office Madison Office Shawano Office Waukesha Office
209 W. 1st Street 2226 Rose Street 201 E 1 Washington Ave. t053A E. Green Bay Street 401 Pilot Court,buite C
Rt 8, Box 8072 la Crosse, WI 54603 P.O. Box 7969 P.O. Box 434 Waukesha, NVI 53 t RB
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i 634 4870 Fax (6
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s 9330 ho
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266
8735 Phone (715 524.3626 Fax (414)
548 86 84
Fax (~t 5; 53a-5 t 50
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,. fax (608) 267-9566
i Fax (715) 524-3633
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