HomeMy WebLinkAbout0153432 - HVAC (associate with replacing CT Simulator) Ci) CITY OF OSHKOSH No 153432
OSHKOSH HVAC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 11/07/201.2_
Contractor TWEET GAROT MECHANICAL INC Category 510-Ind.&Comm-Heating&Ventilating Plan
Inspector Nicole Krahn
Fuel Gas 1 LI :Dii Eletric —
�c Solar I LI-Solid
System ❑ New ❑ Replace I 0 Other
ZI Forced Air _, Radiant 1 �S-team � �A/C
_.- 1E Vent-
❑ Electric ] ❑ Hot Water i [ uppl. _I ❑ Con. Burner ]
Chimney Type ChimneyA O Chimney B O Direct Vent • Not Applicable
Heat Loss 0 As Approved 0 Existing • Not Applicable Value
J
BTU Rate C As Per Plan 0 Variable 0 Other Value
Use/Nature COMM/Hvac associated with replacing the CT Simulator.
of Work
Fees: Valuation $39,869.00 Plan Approval $0.00 Permit Fee Paid $385.00
Issued By: aintii Date 11/07/2012
❑ Permit Voided J 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
D
Divivi sion ion of Inspection nspection Services
P.O.Box 1130
Oshkosh,WI 54903-1130 47)
Phone(920)236-5050
Fax (920)236-5084 o.HKOJH
ON THE WATER
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 permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds. check here
if you want this processed through your account R
**Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
DATE 10/29/12
JOB ADDRESS 500 South Oakwood Road
OWNER Affinity Health System
CONTRACTOR Tweet/Garot Mechanical, Inc.
CHECK RI ALL APPLICABLE
USE CATEGORY
❑Single Family ❑Duplex ❑Multi-Family ❑Rental ®Commercial ❑Industrial
FUEL 12Gas DElectric OSolid SYSTEM ONew ❑Replace
❑Oil ❑Solar ' Other Remodel Existing
TYPE
❑Forced Air ❑Radiant ❑Steam ®A/C MVent ❑Electric 1k.Hot Water ❑Suppl. DCon.Burner
IS CHIMNEY BEING LINED PINo ❑Yes -LINER SIZE &MANUFACTURER
Note:All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE ❑Chimney A ❑Chimney B ❑Direct Vent ®Other
HEAT LOSS DAs Approved ®Existing ❑Not Applicable
BTU RATE DAs Per Plan ❑Variable ®Other Value From Central Plant
DESCRIPTION/SCOPE OF ALL WORK BEING DONE
HVAC work associated with CT Simulator Remodel
VALUE(Including labor and materials)$ 3 9, 8 6 9 . 0 0
ELECTRICAL CONTRACTOR(for projects not requiring an EIV Form) Van Ert
07/07