HomeMy WebLinkAbout0144454-HVAC (2 exam rooms) 10 CITY OF OSHKOSH No 144454
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 12/22/2010
Contractor TWEET GAROT MECHANICAL INC Category 510 - Ind. & Comm - Heating & Ventilating Plan H8- 3203 - 1210 -H
Fuel 11 Gas f Oil u Electric Li Solar ❑ Solid
System 0 New [] Replace Q Other J
u Forced Air u Radiant ❑ Steam J NC ❑ Vent
_ f Electric _ Hot Water Li Suppl. Li Con. Burner
Chimney Type 7 , ) Chimney A () Chimney B ❑ Direct Vent • Not Applicable
Heat Loss n As Approved ❑ Existing • Not Applicable Value
BTU Rate 0 As Per Plan ❑ Variable • Other Value
Use /Nature COMM (MERCY MEDICAL CENTER / RELOCATION OF DIFFUSERS AND GRILLES TO CREATE TWO EXAM ROOMS FROM
of Work EXISTING ZONE * *check #76158
Fees: Valuation $3,975.00 Plan Approval $0.00 Permit Fee Paid $70.00
Issued By: ) y�� f�'' Date 12/22/2010
❑ Permit Voided Parcel Id # 0613660000
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 PO BOX 11767 GREEN BAY WI 54307 - 1767 Telephone Number 920 -498 -0400
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 performed within two business days from the time the project is ready.
City oOfsh
Division si o In
on of Inspection Services
P.O. Box WI 1130
5
Oshkosh, WI 54903 -1130
411)
Phone (920) 236 -5050
Fax (920) 236 -5084 OJHKIJJH
ON TNP WATFR
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
® 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 permits) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds. check here
if you want this processed through your account n
DATE 12/17/10
JOB ADDRESS 500 S. Oakwood
OWNER Affinity Health Systems H g r 3 0� 0 3 --la 16 6-I
CONTRACTOR Tweet Garot Mechanical, Inc.
CHECK 0 ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi - Family [Mental lommercial ❑Industrial
FUEL [}Gas ❑Electric ❑Solid SYSTEM ❑New DRe lace
❑Oil ❑Solar ❑Other Central Plant
TYPE
lifForced Air ❑Radiant ❑Steam DA/C ❑Vent ❑Electric ❑Hot Water DSuppl. ❑Con. Burner
IS CHIMNEY BEING LINED ❑No ❑Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ❑Other
HEAT LOSS DAs Approved DExisting RINot Applicable
BTU RATE DAs Per Plan ❑Variable ❑Other Value
DESCRIPTION OF ALL WORK BEING DONE Relocation of diffusers and grilles to create
two exam rooms from existing zone.
VALUE (Including labor and all materials including light fixtures) $ 3975.00
ELECTRICAL CONTRACTOR Excellence Electric
For applicable projects, an Electric Installation Verification form, sign e
attached. IF not attached or not applicable, a separate Electrical Permit i s _..
.yZiiF k '..
DEC 1 7 2010
Ili i r4 ? i fi I 3/02
COMM T' JEVr LO; lviEN e
INSPECTION ` ERVICES °, /IS;ON