HomeMy WebLinkAbout2006-Certificate of Occupancy
CITY HALL
Inspection Services Div
215 Church Avenue
~POBOX1130
~ Oshkosh WI
~ 54903-1130
OfHKOfH
ON THE WATER
City of Oshkosh
Approved:
March 1, 2006
GDS Properties LLC
4466 Harbor Village Drive
Omro, Wisconsin 54963-9499
CERTIFICATE OF OCCUPANCY
An Occupancy Permit is hereby issued for the new building, located at 1961 S.
Washburn Street, Oshkosh, Wisconsin 54904-8292 as described in Building
Permit Application number(s) 115810 & 116049.
This building is to be used only as an animal hospital and is located in the C-2,
General Commercial District.
CONDITIONS:
1) Landscaping and screening to be completed by 6/1/06.
2) Fan cycle of HVAC system must operate continuously when building is
occupied.
LIMITATIONS:
Maximum number of persons:
50 Occupants
A new Certificate of Occupancy shall be required prior to occupancy, should
additional building(s) be erected, or should any buildings mentioned above be
altered or moved. The use of land, or buildings, shall not be changed until a
Certificate of Occupancy is issued for that occupancy. All conditions noted
above must be complied with in order for this ific e to e valid.
01
cc: Ganther Construction.
Building Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 0116049 Create Date 8/29/2005
OWner
Categóry 230 - New Stores & Customer Service
Contractor GANTHER CONSTRUCTION
Type . Building
Zoning C-2
a Sign
a Canopy
0 Fence
0 Raze ~ Plan P8-60-0806
Class of Const:
VB
Size 4858 sq It
Value
$321,782.00
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-FI.
Rooms ------'1 Bedrooms 0 Baths 0
Garage ~ Sq. FI.
n Projection I
Stories 1
Height ~ Ft.
a Floating Slab
a Post
Canopies ~ Signs 0
Foundation. Poured Concrele
a Concrete Block
a Pier
a Treated Wood
a Other
Park Dedication
Not Required
Flood Plain ~
# Dwelling Units ~
Height Permit Not Required
# Structures
Occupany Permit Required
Use/Nature Comm / Work above grade for the construction of 4858 sq It new building for animal hospitai as per plans.
of Work Note: All mechanical equipment shall be screened.
HVAC Contr
Plumbing Contr
Electric Contr
Inspections:
Date 10/14/2005 -'----------
Type Rough In - Inspector Allyn Oannhoff
approved w/cond.
REQUEST LINE / ALSO REQUESTED INSPECTION FOR ELECTRIC SOFFIT LIGHTING. OUTSIDE ONLY (NOTE TO KB) SEE FCN
DatelTime requested:
Access:
~~
10/12/2005 07:17 AM
Notice Type:
Phone Number: JEFF 376-0227
Ready DatelTime: 10/12/200507:17 AM Requested By: GANTHER CONSTRUCTION
a Reinspect Fee a Fee Waived
0 Reinspect Fee Paid
Date Type Inspector Allyn Dannhoff no time
~~
Request Line - ex!. wall & vapor barrier & vapor barrier at ceiling. 10/24/05 AD OUT OF OFFICE ON 10/20 & 10/21 OK TO PROCEED
DatelTime requested:
Access:
10/19/2005 02:47 PM
Notice Type:
Phone Number:
~~
Ready DatelTime: 10/19/200502:47 PM Requested By: GANTHER CONSTRUCTION-Jeff
a Reinspect Fee a Fee Waived
0 Reinspect Fee Paid
Page 1 of3
Building Permit Work Card
Job Address 1961 SWASHBURNST Permit Number 0116049 CreateDate 8/29/2005
OWner
Categôry 230 - New Stores & Customer Service
Contractor GANTHER CONSTRUCTION
Type. Building
Zoning C-2
0 Sign 0 Canopy 0 Fence 0 Raze
Class of Const: VB Size 4858 sq It
Plan P8-60-0806
Value $321.782.00
Garage ~ Sq. FI.
n Projection I
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-Ft.
Rooms 0 Bedrooms ~ Baths 0
Stories 1
Height ------'1 FI.
0 Floating Slab
0 Post
Canopies
0 Signs
Foundation. Poured Concrete
0 Concrete Block
0 Pier
0 Treated Wood
0 Other
Occupany Permit Required
Flood Plain No
Height Permit Not Required
Park Dedication
Not Required
# Dwelling Units ~
# Structures
Use/Nature omm / Work above grade for the construction of 4858 sq It new building for animal hospital as per plans.
of Work Note: All mechanical equipment shall be screened.
HVAC Contr
Plumbing Contr
Electric Contr
Inspections:
Date Type Inspector Allyn Dannhoff no time
~~
Request Line - insulation & vapor barrier-we are drywalling now. 10/24/05 AD OUT OF OFFICE ON 10/20 & 10/21. OK TO PROCEED
Date/Time requested:
Access:
10/20/2005 03:08 PM
Notice Type:
Phone Number: 376-0227
~~
Ready DatelTime: 10/20/200503:08 PM Requested By: GANTHER CONSTRUCTION-Jeff
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Date 1/10/2006 -'----------
Type Final
Inspector Allyn Dannhoff
not approved
REQUEST LINE / WOULD LIKE INSPECTION TUESDAY
SEE FCN
DatelTime requested:
Access:
1/6/2006 11:28AM
~~
Notice Type:
Phone Number: JEFF 376-0227
pONTACT JEFF 1/2 TO 3/4 HOUR AHEAD OF INSPECTION. HE WANTS TO BE PRESENT
Ready DatelTime: --'------ Requested By: GANTHER CONSTRUCTION
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Page2of3
Building Permit Work Card
Job Address 1961SWASHBURNST Permit Number 0116049
Create Date 8/29/2005
OWner
Categôry 230 - New Stores & Customer Service
Contractor GANTHER CONSTRUCTION
Type. Building
Zoning C-2
0 Sign 0 Canopy 0 Fence 0 Raze
Class of Const: VB Size 4858 sq It
Plan P8-60-0806
Value
$321,782.00
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-FI.
Rooms 0 Bedrooms ------'1 Baths ~
Garage ~ Sq. Ft.
n Projection I
Stories 1
Foundation. Poured Concrete
0 Concrete Block
Height ~ FI.
0 Floating Slab
0 Post
Canopies
0 Signs 0
0 Pier
0 Treated Wood
0 Other
Occupany Permit Required
Flood Plain No
Height Permit Not Required
# Structures
Park Dedication
Not Required
# Dwelling Units ~
Use/Nature Comm / Work above grade for the construction of 4858 sq It new building for animal hospital as per plans.
of Work Note: All mechanical equipment shall be screened.
HVAC Contr
Plumbing Contr
Electric Contr
Inspections:
Date 1/20/2006 -'----------
Type Re Final
Inspector Allyn Dannhoff
approved w/cond.
¡request line
B & H T.O.P. OK WHEN HVAC INSTALLATION IS COMPLETE
DatelTime requested: 1/19/2006 01:17 PM Notice Type: Phone Number: Jeff 376-0221
~~
Access:
Ilf locked key for front door in recpt elec box on east side of bldg around corner from vestibule
Ready DatelTime: - -'------ Requested By: GANTHER CONSTRUCTION
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Date 3/1/2006 --'----
Type Final
Inspector Allyn Dannhoff
approved 'w/eand.
LANDSCAPING & SCREENING TO BE COMPLETE BY 6/1/06.
I "'" '"'~OO "'=,,~
DatelTime requested:
Access:
FAN CYCLE OF HVAC SYSTEM MUST OPERATE CONTINUOUSLY
~~
Notice Type:
Phone Number:
Ready DatelTime: - -'------ Requested By:
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Page 3 of 3
" Building Permit Work Card
Job Address' 1961 S WASHBURN ST Permit Number 0115810 CreateDate 8/17/2005
Owner
Contractor GANTHER CONSTRUCTION
Category 230 - New Stores & Customer Service
Type. Building
Zoning C-2
0 Sign 0 Canopy 0 Fence 0 ~ Plan P8-60-0806
Class of Const: VB Size 4858 sq It Value $18.494.00
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-FI.
Rooms 0 Bedrooms ~ Baths ~
Garage ~ Sq. FI.
n Projection I
Stories 1
Foundation. Poured Concrete
0 Concrete Block
Height ~ FI.
0 Floating Slab
0 Post
Canopies
0 Signs 0
0 Other
0 Pier
0 Treated Wood
Occupany Permit Not Required
Flood Plain No
Height Permit Not Required
Park Dedication
Not Required
# Dwelling Units ~
# Structures
0
Use/Nature Comm / FOUNDATION ONLY - No above grade work will be permitted until additional permits are obtained
of Work alter drainage plan and landscape plan have been approved.
HVAC Contr
Plumbing Contr
Electric Contr
Inspections:
Date 8/26/2005 -'----------
Type Footings
Inspector Allyn Dannhoff
no time
r""""" -,~ 00.' m~"'. .wo 00 ""," -,.
DatelTime requested: 8/25/2005 08:09 AM Notice Type:
Access:
Phone Number: 920-731-5464
Ready DatelTime: 8/25/200~ 12:00 PM Requested By: Delrar-Laurie
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Date 8/26/2005 -'----------
Type Footings - Inspector Allyn Dannhoff
no time
Request Line - wants someone there at 1 :30 today - if there is a problem. call
DatelTime requested:
Access:
8/25/2005 10:23 AM
Notice Type:
Phone Number: none given
Ready DatelTime: 8/25/2005 01 :30 PM Requested By: Delrar - Laurie
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Page 1 of2
Building Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 0115810 Create Date 8/17/2005
OWner tA
Contractor GANTHER CONSTRUCTION
Category 230 - New Stores & Customer Service
Type. Building
Zoning C-2
0 Sign
0 Canopy
0 Fence
0 Raze
Plan P8-60-0806
Value $18,494.00
Garage ~ Sq. Ft.
n Projection I
Class of Const:
VB
Size 4858 sq It
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-FI.
Rooms 0 Bedrooms ~ Baths ~
Stories 1
Height ~ FI.
0 Floating Slab
0 Post
Canopies
0 Signs 0
Foundation. Poured Concrete
0 Concrete Block
0 Pier
0 Treated Wood
0 Other
Occupany Permit Not Required
Flood Plain No
Height Permit Not Required
Park Dedication
Not Required
# Dwelling Units ~
# Structures
0
Use/Nature ¡Comm / FOUNDATION ONLY - No above grade work will be permitted until additional permits are obtained
of Work alter drainage plan and landscape plan have been approved.
HVAC Contr
Electric Contr
Plumbing Contr
Inspections:
Date ~ -'---------- Type Foundation Backfill
[" "" , =C ~rn "O,,~
DatelTime requested: 8/30/2005 10:50 AM
Access:
Inspector Allyn Dannhoff
no time
Notice Type:
Phone Number: JEFF 376-0227
Ready DatelTime: 8/30/2005 10:50 AM Requested By: GANTHER CONSTRUCTION
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Page 2 of 2
HVAC Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number
co,
116982 Cre~te Date 10/20/2005
OW,?er
GDS PROPERTIES LLC
Contractor CHRISTENSEN HEATING & AIC INC
Plan P8-60-0806
Category 512 - Ind. & Comm-Both
Fuel ~ i::IQiC=:J I I ElectriC¡ ~
System PI New n Replace
b'J Forced Air
U Electric
I U Steam
I U Suppl.
~ Value
n Other
I U Vent
I
$34,850,00
i U Radiant
1 U HotWater
I b'J AIC
I U Con. Bumer
~
I
Chimney Type 0 Chimney A 0 Chimney B . DirectVent () Not Applicable
Heat Loss . As Approved 0 Existing () Not Applicable I Value
BTU Rate . As Per Plan 0 Variable 0 Other I Value
Use/Nature IND/ EARLY START PERMIT - Hvac system as per plans submitted. NO WORK MAY BE I
of Work CONCEALED UNTIL STATE APPROVED PLANS ARE RECIEVED AND INSPECTION IS APPROVED! I
tnspections:
Date 1/10/2006
Type Final
Inspector Allyn Dannhoff
not approved
r~""
DatelTime requested:
Notice Type:
Phone Number:
Access:
Ready DatelTime:
Requested By:
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Date
Type Final
Inspector Allyn Dannhoff
approved w/cond.
.O.P. OK WHEN HVAC INSTALLATION IS COMPLETE
DatelTime requested:
Notice Type:
Phone Number:
Access:
L
Ready DatelTime:
Requested By:
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
HVAC Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 116982 Create Date 10/20/2005
.<
O't'ner GDS PROPERTIES LLC Contractor CHRISTENSEN HEATING & AlC INC
Category 512 -Ind. & Comm-Both Plan P8-60-0806
Fuel ~ IT2iC:J I I Electric I ~ ~ Value $34,850.00
System PI New I 0 Replace I 0 Other I
~ Forced Air I U Radiant I U Steam I ~ AlC I U Vent I
U Electric I U HotWater I U Suppl. I U Con. Burner I
Chimney Type D Chimney A 0 Chimney B . DirectVent 0 Not Applicable I
Heat Loss . As Approved Û Existing 0 Not Applicable I Value 0
BTU Rate . As Per Plan 0 Variable 0 Other I Value
Use/Nature INDI EARLY START PERMIT - Hvac system as per plans submitted. NO WORK MAY BE I
of Work [ oo~m "~" ~,~ ~_m """ AA' ~O~O ~O "~,~,, "~-'"
Inspections:
Date 3/1/2006
Type
Inspector
FAN CYCLE OF HVAC SYSTEM MUST OPERATE CONTINUOUSLY WHEN BUILDING IS OCCUPIED.
DatelTime requested:
Notice Type:
Phone Number:
Access:
Ready DatelTime:
Requested By:
0 Reinspect Fee 0 Fee Waived
0 Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 115800 Create Date 08/16/2005
OWner Contractor O'NEILL ENTERPRISE INC
Category 440 - Ind~strial-interior Plan Value $25.000.00
Bathtub . ---1 Shower ---..!1 Water Softner 0 Wait.SI. ---..!1 Shamp Sink ---..!1 Coffee Maker ---..!1
Whirlpool 0 Floor Drain ~ Local Waste 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0
Lavatory ~ Lndry Tray ---1 Clothes Wshr 0 Exam Sink ----2 Catch Basin ---..!1 Ex! Grease Trap ---..!1
Toilet ~ Disposal ---..!1 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve ---..!1
Res. Sink ---..!1 Dishwasher ~ BeerTap 0 Hand Sink ---..!1 Urinal ---..!1 Eye Wash Statn ---..!1
Bar Sink 0 Sump Pump ---..!1 Lab Sink 0 Plaster Sink ---..!1 Standp Rec 1 Wtr Sewer Mtrs 0
Water Heater 1 Classrm Sink ---..!1 Sterilizer 0 Surgeons Sink ---..!1 Ice Maker ---..!1 Deduct Meters ---..!1
Site Drain 1 Breakrm Sink ---1 DipWell 0 F Prep Sink ---..!1 Gar Drain ---..!1 Wtr Usage Mtrs ---..!1
Roof Drain ---..!1 Ejector/Grind ---..!1 Drink Ftn 0 Serv Sink ~ Soda Disp ---..!1
Misc. 0
Fixtures
Use/Nature [Interior/ExteriOr Plumbing for new veterinary clinic. (Debit Account) I
of Work
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 2" Plastic Lateral 1 New
0
0
0
0
Date Type Underground Inspector Allyn Oannhoff no time
REQUEST LINE / WOULD LIKE INSP @ 2 PM9/8/05 STAFF NOT AVAILABLE TO PERFORM INSPECTION
DatelTime requested:
9/1/2005 03:18 PM
Notice Type:
Telephone Number:
Access:
Ready DatelTime: 9/1/2005 03:18 PM Requested By:
0 Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 115800 Create Date 08/16/2005
Owner Contractor O'NEILL ENTERPRISE INC
Category 440 - Industrial-Interior Plan Value $25,000.00
Bathtub ----.1 Shower ~ Water Softner ~ Wail.SI. ~ Shamp Sink ~ Coffee Maker 0
Whirlpool' ~ Floor Drain ~ Local Waste ~ Ice Chest ~ FlrlWstSink ~ Int Grease Trap ~
Lavatory ~ Lndry Tray ----.1 Clothes Wshr 0 Exam Sink 7 Catch Basin ~ Ext Grease Trap 0
Toilet ~ Disposal ~ Bidet ~ Sculry Sink ~ Wash Ftn ~ RPZ Valve ~
Res. Sink ~ Dishwasher -----1 BeerTap ~ Hand Sink ~ Urinal ~ Eye Wash Statn ~
Bar Sink ~ Sump Pump ~ Lab Sink 0 Plaster Sink ~ Standp Rec ---.! Wtr Sewer Mtrs 0
Water Heater ----.1 Classrm Sink ~ Sterilizer ~ Surgeons Sink ~ Ice Maker ~ Deduct Meters ~
Site Drain ----.1 Breakrm Sink ----.1 DipWell 0 F Prep Sink 0 Gar Drain ~ Wtr Usage Mtrs 0
Roof Drain ---.<> Ejector/Grind ~ Drink Ftn ~ Serv Sink 2 Soda Disp ~
Misc. ~
Fixtures
Use/Nature I I
of Work Interior/Exterior Plumbing for new veterinary clinic. (Debit Account)
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 2" Plastic Lateral 1 New
0
0
0
0
Type Sewer/Water
Inspector
Date
I~o~ooml~~"
DatelTime requested: 9/15/200511:47 AM
Notice Type:
Telephone Number:
PAT 589-2007
Access:
Ready DatelTime: 9/16/2005 ~ Requested By: O'NEILL ENTERPRISE INC
0 Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 115800 Create Date 08116/2005
OWner Contractor O'NEILL ENTERPRISE INC
Category 440" Industrial-Interior Plan Value $25,000.00
Bathtub ~ -----1 Shower ----.!1 Water Softner 0 Wait. St. ----.!1 Shamp Sink ----.!1 Coffee Maker ----.!1
Whirlpool ----.!1 Floor Drain 9 Local Waste 0 Ice Chest ~ FlrlWst Sink ~ Int Grease Trap ----.!1
Lavatory ~ Lndry Tray -----1 Clothes Wshr 0 Exam Sink ---.l Catch Basin 0 Ext Grease Trap ----.!1
Toilet 3 Disposal ----.!1 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Res. Sink ----.!1 Dishwasher 2 Beer Tap 0 Hand Sink ~ Urinal ~ Eye Wash Statn ~
Bar Sink 0 Sump Pump ----.!1 Lab Sink 0 Plaster Sink ~ Standp Rec ----.! Wtr Sewer Mtrs ~
Water Heater 1 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker ~ Deduct Meters ~
Site Drain -----1 Breakrm Sink -----1 DipWell 0 F Prep Sink ~ Gar Drain ~ Wtr Usage Mtrs ~
Roof Drain 0 Ejector/Grind ----.!1 Drink Ftn 0 Serv Sink 2 Soda Disp ~
Misc. ----.!1
Fixtures
Use/Nature ¡Interior/ExteriOr Plumbing for new veterinary clinic. (Debit Account) I
of Work
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 2" Plastic Lateral 1 New
0
0
0
0
Type Rough In
Inspector
Date
REQUEST LINE / REQUESTEO ABOVE GROUND INSPECTION
DatelTime requested:
1 0/131200!07:59 AM
Notice Type:
Telephone Number:
LAURIE 230-2007
Access:
10PEN
Ready DatelTime: 10/13/200! 07:59 AM Requested By: O'NEILL ENTERPRISE INC
0 Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid
Job Address 1961 S WASHBURN ST
OWner
Category 440 - Industrial-Interior
Bathtub . 1 Shower
.
Whirlpool --2 Floor Drain
Lavatory ---1 Lndry Tray
Toilet 3 Disposal
Res. Sink --2 Dishwasher
Bar Sink 0 Sump Pump
Water Heater 1 Classrm Sink
Site Drain ------Î Breakrm Sink
Roof Drain 0 Ejector/Grind
Misc. --2
Fixtures
Use/Nature
of Work
--2
~
~
--2
~
--2
--2
~
--2
Plumbing Permit Work Card
Permit Number 115800
Contractor O'NEILL ENTERPRISE INC
Plan
Water Sollner 0
Local Waste 0
Clothes Wshr 0
Bidet 0
Beer Tap 0
Lab Sink 0
Sterilizer 0
Dip Well 0
Drink Ftn 0
-
Wait.St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Interior/Exterior Plumbing for new veterinary clinic. (Debit Account)
Sanitary Sewer
Size
4"
Storm Sewer
Water Service
2"
Date 1/11/2006
Type Final
Inspector Paul Wolf
Material
Plastic
Plastic
Type
Lateral
Lateral
#
1
0
0
0
0
0
0
0
0
0
Conn.Type
New
~
0
7
~
~
~
~
~
2
Shamp Sink ~
FlrlWst Sink ~
Catch Basin 0
Wash Ftn --2
Urinal 0
Standp Rec ------Î
Ice Maker 0
Gar Drain ~
Soda Disp 0
aþþrôlÎed w/cond.
Create Date 0811612005
Value
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
$25,000.00
0
~
~
~
0
~
~
~
1
0
0
0
0
New
Request Line & faxWAITING TO SET SURGICAL TUB & DW IN KENNEL
DatefTime requested:
1/101200611:37AM
Access:
Notice Type:
Telephone Number:
230-2007
Ready DatelTime: 1/1012006 11:37 AM Requested By: O'NEILL ENTERPRISE lNG-Laurie
0 Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid
Electric Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 116568 Create Date 09/30/2005
OWner GDS PROPERTIES LLC
Contractor MORRIS ELECTRIC INC
Category 642 - Commercial-New Building Wiring
0 ChangeO Temp O~ Type 0 Overhead
Switches
0
. Underground 0 N/A
Fixtures ~
Receptacles 0
Value $40.000.00
Service b New
Volts 120/208
Amps 400
Circuits
Fee
$304.00 0
Appliances
Use/Nature
Of Work
I'~'-".'
Inspections:
Date 10/12/2005
Type Rough In
Inspector Kevin Benner
approved w/cand.
REQUEST LINE / JEFF REQUESTED A ROUGH-IN INSP FOR BLDG. ALSO REQUESTED INSPECTION
FOR ELECTRIC SOFFIT LIGHTING, OUTSIDE ONLY
The north & west sides was all that was done at the time of inspection
DatelTime requested: 10/12/2005 07:17 AM
Access:
Notice Type:
Phone Number: 376-0227
Ready Date/Time: 10/12/2005 07:17 AM Requested by:
-~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
GANTHER
JEFF
Date 10/14/2005 Type Rough In
I~~"OO'
DatelTime requested: 10/14/2005 08:16 AM
Access:
Evan will be on site
Inspector Kevin Benner
approved
Notice Type:
Phone Number:
Ready Date/Time: 10/14/200508:16 AM Requested by:
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Electric Permit Work Card
Job Address 1961SWASHBURNST Permit Number 116568
Create Date 09/30/2005
Owner GDS PROPERTIES LLC
Contractor MORRiS ELECTRIC INC
Category 642 - Commercial-New Building Wiring
0 ChangeO Temp 0 NïA Type 0 Overhead
Circuits
. Underground 0 N/A
Service p New
Volts 120/208
Fee
$304.00 0
Fixtures 0
Receptacles 0
Value $40,000.00
-
I
Amps
400
Switches 0
Appliances
Use/Nature
of Work
r~ ,~.
Inspections:
Date
Type Underground
Inspector Kevin Benner
not approved
An inspection was not requested and it was noted that the installation was done when I was on site for an
interior inspection.
DatelTime requested: 10/14/2005 00:00 AM
Access:
Notice Type: ~ Phone Number:
Ready DatelTime: 10/13/2005 00:00 AM Requested by:
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Date 10/24/2005
Type Rough In
Inspector Kevin Benner
approved w/cond.
Request Line
Reviewed the sign wiring requirements, noted that the "0" on hospital is installed upside down. so there is not
any weep holes for that letter. Discussed the wiring requirements for the emergency lighting wiring methods
DatefTime requested: 10/20/2005 01:21 PM
Access:
Someone on the job Friday
Ready DatelTime: 10/21/2005 07:00 AM Requested by:
-~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Notice Type:
Phone Number:
MORRIS ELECTRIC lNG-John
Electric Permit Work Card
Job Address 1961 S WASHBURN ST
Permit Number 116568
Create Date 09/30/2005
Owner GDS PROPERTIES LLC
Contractor MORRIS ELECTRIC INC
Category 642 - Commercial-New Building Wiring
0 ChangeO Temp 0 ~ Type 0 Overhead
Service p New
Volts 120/208
Amps 400
. Underground 0 N/A
Circuits 0
Fee
$304.00 0
Fixtures 0
Receptacles 0
Value $40.000.00
Switches 0
Appliances
Use/Nature
of Work
I"" -".
Inspections:
Date 12/06/2005
Type Service
Inspector Kevin Benner
approved
Request Line
Faxed to WPS 12/06/05. Mailed 12/19/05
DatelTime requested: 12/02/2005 01:08 PM
Access:
Open
Notice Type:
Phone Number:
Ready Date/Time: 12/02/200501:08 PM Requested by:
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
MORRIS ELECTRIC INC
Date 01/18/2006 Type Final
I"'"'~ ""
DatelTime requested: 01/16/2006
Access:
CALL TO SCHEDULE, WANTS TO BE PRESENT
Ready Date/Time: 01/16/200601:25 PM Requested by:
-~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Inspector Kevin Benner
not approved
01:25 PM
Notice Type: FC
Phone Number: JOHN 858-1575
MORRIS ELECTRIC INC
Electric Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 116568 Create Date 09/30/2005
OWner GDS PROPERTIES LLC
Contractor MORRIS ELECTRIC INC
Category 642 - Commercial-New Building Wiring
Service pNew 0 ChangeO Temp O~TYPe 0 Overhead
Volts 120/208 Circuits
Amps 400 Switches
. Underground 0 N/A
Fee
$304.00 0
Fixtures 0
Receptacles 0
Value $40,000.00
Use/Nature
of Work
I
ì~ ""~,
~
I
Appliances
Inspections:
Type ~,,-Final
Inspector Kevin Benner
not approved
Date 01/27/2006
Request Line
Letters in the sign were not inverted and the exterior EM luminairs need to be caulked
X-Ray equipment is not installed
DatelTime requested: 01/27/2006 07:00 AM
Access:
Wants to be present.
Ready DatefTime: 01/27/2006 09:00 AM Requested by:
--~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Notice Type:
Phone Number: No number given
No name given
Date 01/27/2006
Type ~ Final
Inspector Kevin Benner
approved w/cond.
The EM Luminaires were caulked, need verification that the sign installation is correct. Emailed UL for
verification.
X-Ray not installed
DatefTime requested: 01/27/2006 09:30 AM
Access:
Notice Type:
Phone Number:
Ready DatelTime: 01/27/2006 10:30 AM Requested by:
--~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
<.-,'c:
Electric Permit Work Card
Job Address 1961 S WASHBURN ST
Permit Number 116568 Create Date 09/30/2005
Contractor MORRIS ELECTRIC INC
OWner GDS PROPERTIES LLC
Category 642 - Commercial-New Building Wiring
Service b New 0 ChangeO Temp 0 ~ Type 0 Overhead
Volts 120/208 Circuits 0
Amps 400 Switches 0
. Underground 0 N/A
Fixtures
0
Fee
$304.00 0
Receptacles
Value
$40,000.00
Use/Nature
of Work
L
I"" "œ~'
-
~~-
Appliances
Inspections:
Date 0210212006__.- Type Re Final
Inspector Kevin Benner
approved
I-~
DatelTime requested: 02101/2006 01:40 PM
Access:
Notice Type:
Phone Number: 85801575
Ready DatelTime: 02101/2006 01 :40 PM Requested by:
-~
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
MORRIS ELECTRIC lNG-John
Building Permit Wórk Card
1961 S WASHBURN ST Permit Number 0116049 Create Date 8/29/2005
Contractor GANTHER CONSTRUCTION
230 - N~w Stores & Customer Service
0 Sign -0 Canopy 0 Fence 0 Raze
Class of Cons!: VB Size 4858 sq It
Plan P8-60-0806
Value
$321.782.00
0
Sq. Finished/Living 0 Sq. Ft.
-FI.
Bedrooms ~ Baths ~
Garage ~ Sq. FI.
n Projection I
Height ~ FI.
0 Floating Slab
0 Post
Canopies ~ Signs 0
. Poured Concrete
0 Concrete Block
0 Pier
0 Treated Wood
0 Other
Required
Flood Plain No
Height Permit Not Required
# Structures
Not Required
# Dwelling Units ~
[COrnm / Work. above grade for the construction of 4858 sq ft new building for animal hospital as per plans.
Note: All mechanical equipment shall be screened.
Plumbing Contr
Type Re Final
yo.:P
Ðk.
Date/Time requested: "1/1912006 01:17 PM Notice'Type:'
--~
Access:
Ilf locked key for front door in recpt elec box on east side of bldg around ~or~er from vestibule
'jèii:i76-0ZZ1
0 Reinspect Fe~ 0 Fee Waived
0 Reinspect Fee Paid
F,'J~ /j/- cC r II-b
~~-s;~ - '¡'le~
}/ tr ~r:' C-7~tllIC- S:l~~ ~
7 (9'r~~ ~"i;:~ '~cr ~~&t.
Building Permit Work Card
Job Address 1961 S WASHBURN ST Permit Number 0116049 CreateDate 8/29/2005
Owner
Contractor GANTHER CONSTRUCTION
Category 230 - Nßw Stores & Customer Service
Type. l;iuilding
Zoning C-2
0 Sign
o-tãnÕpŸ"- 0 Fen,e
0 Raze
I Plan P8-60-0806
Value $321.782.00
Garage ~ Sq. Ft.
n Projection I
Class of Const:
VB
~~ Siz~ 4858 sq It
Unfinished/Basement 0 Sq. Finished/Living 0 Sq. FI.
-FI.
Rooms ~ Bedrooms 0 Baths ~
Stories
Height 0 FI. Canopies 0 Signs ~
0 Floating Slab 0 Pier 0 Other
0 Post 0 Treated Wood
i
Foundation. Poured Concrete
0 Concrete Biock
Occupany Permit Required
Flood Plain No
Height Permit Not Required
Park Dedication
Not Required
# Dwelling Units ~
# Structures
---1
Use/Nature Comm / Work above grade for the construction o(4ß.5?sq It new building for animal hospital as per plans.
of Work Note: All mechanical equipment shall be screened.
HVAC Contr
Plumbing Contr
Electric Contr
Inspections:
Date ~ -'---------- Type Inspector Áilyn Dannhoff no time
Request Line - insulation & vapor barrier - we are drywalling now. 10/24/05 AD OUT OF OFFICE ON 10/20 & 10/21., 01< T()~PROC.E.E.D
Date/Time reqo'ested:
Access:
0 Reinspect Fee Paid
EEFCN
Date/Time requesíed:
Access:
Building Permit Work Card
1961 S WASHBURN ST P~ermit ~umber 0116049 Create Date 8/29/2005
Contractor GANTHER CONSTRUCTION
~ew Stores & Customer Service
0 Sign 0 Canopy 0 Fence 0 Raze
Class of Const: VB Size 4858 sq ft
~
1
- ~i' Finished/Living ~ Sq. FI.
Bedrooms ~ Baths ~
I Plan P8-60.0806
Value $321,782.00
Garage ~ Sq. FI.
0 Projection I
tt~t9ht~ FI. Canopies 0 Signs 0
0 Floating Slab 0 Pier 0 Other
0 Post 0 Treated Wood
. Poured Concrete
0 Concrete Block
Required
Not Required
Flood Plain ~
# Dwelling Units ~
Height Permit Not Required.
# Shuctures
----.1
Comm / Work above grade for the construction 014858 sq It new building for animal hospital as per plans.
Note: All mechanical equipment shall be screened.
Plumbing Contr
Date 10/14/2005 -'---------- 'Type Rõùgh in" ,
'¡¡'spéê'íô, ìífiynr:Jã1ïiÍhòíi'
. app'ô;;ed"viicond.
REQUEST LINE / AlSO REQUESTED INSPECTION FOR'TIEÓÌ'Rrc'so ,., ii'ÜGHllNG, ÕUTSI'Ó'Ë ON[Ÿ\Ñ'órÉro KB)SÉ'Ë FeN
Date/Time requested:
Access:
10/12/2005 ~
Notice Type:
JEFF 376-0227
I
I
i
Ii
"'~""r=~'-"""'M'~"m."__,._.""j
~
,."'~-.",,..," "-"",""',-
Ready Date/Time: 10/12l2005 Ò7:17 AM Requested By: GANTHER CONSTRUCTIOI\f
, ,0 Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid
----",--",-."-~"",.,,
. .
Date --'---------- . type"'~"'~""---"""'-""-"'-fñšpêêtõr""A":uý~[¡áññiîõ11-""':'-'.--""""""."""""'.'"""".""ñõïi"{õ""_",.._.,,..,,. --.,," .'j¡,
l"~ ",'" @ ~" -, ~-,' -, ~~, ~.'"' '",,""Ó-'M" ""'" 00'"" ,,¡,¡¡ õ<ro~"-_.,,
DatelTime requested: 10/19/2005 02:47 ÞM í\íotice Týpe: Phone Number:
Access:
litf",." commerce.wi.gov
\:LJ !~~9 !1!JX!
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisconsin.gov
AUG 29 2005
Jim Doyle, Governor
Mary P. Burke, Secretary
____DEPAinMENT OF
I.AJWíiVIUì~11 Y '1JI::.n;l.IJrl1i1l:.i~ I
August 26, 2005
CUSTJDNo.674170
ATTN: Buildings & Structures Inspector
ANDY DUMKE
GDS PROPERTIES LLC
601 OREGONST STEA
OSHKOSH WI' 54902-5965
BUILDING INSPECTION
CITY OF OSHKOSH
POB 1130
OSHKOSH WI 54902
REGISTRATION OF COMMERCIAL BUILDING SITE
EROSION CONTROL NOTICE OF INTENT
SITE:
The Animal Hospital òf Oshkosh
1961 S. Washburn and 20TH Avenue
City of Oshkosh
FOR:
Description: NO!
Object Type: Soil Erosion Contròl Regulated Object JDNo.: 1037237
Anticipated end date: 05/31/2006; Anticipated start date: 09/02/2005; I Acres disturbed area
This letter aclmowledges receipt of a Notice ofIntent with our agency.
By virtue of the owner's siguature on the application form, he/she has indicated that a long-term stormwater
management plan meeting the requirements set forth in NR 216.47 has been developed and will be implemented.
Please note:
I. That at this time there will be no review conducted by the Department of Commerce of the stormwater
management plans for this project.
2. That there will be no routine inspections conducted by the Department of Commerce during the construction of
this project.
3. The owner shall retain the above mentioned stormwater management plan on the construction site and make it
available to state and/or local inspectors on demand.
4. That plan review and/or inspections by the lòcal municipality and/ or DNR may be required by local permitting
ordinances or DNR rules.
Inquiries concerning this colTespondence may be made to me at the telephone number listed below, or at the address
on this letterhead. Please refer to the Transaction ill No. referred to in the regarding line when making an inquiry
or submitting additional information.
Sincerely,
~~
Laura Brood
Customer Service Representative, Integrated Services
(608)785-9308, M - F7:45 am - 4:30 pm
lbrood@commerce.state.wi.us
cc: Peter R Ochs, Building Inspector, (920) 948-3500, Friday, 7:45 A.M. - 4:30 P.M.
Steve Kaiser, Larson Engineering
Safety and Buildings
2331 SAN LUIS PL STE 150
GREEN BAY WI 54304
TDD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisconsln.gov
~ commerce.wi.gov
November isconsin
Department of Commerce
CUSTIDNo.132425
Jim Doyle, Governor
Mary P. Burke, Secretary
ATTN: Buildings & Structures Inspector
JEFFREY OLENICZAK
MONROE EQUIPMENT INC
N50 W13941 OVERVIEW DR
MENOMONEE FALLS WI 53051
BUILDING INSPECTION
CITY OF OSHKOSH
POB 1130
OSHKOSH WI 54902
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11118/2006
SITE:
The Animal Hospital of Oshkosh
1961 S. Washburn and 20TH Avenue
City of Oshkosh
FOR:
Object Type: HV AC ICC System Regulated Object ID No.: 1046619
4,858 sq ft Area Heated
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defmed in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
IMC 313/Comm 64.0313(3) All operating manuals concerning the HV AC equipment and its maintenance shall
be presented to the owner.
IMC 313/Comm 64.0313(1) HV AC system balancing shall be performed, and a report shall be made available
to the department upon request.
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by anthorized representatives of the Department, which may include local inspectors. Ifplan index sheets
were submitted in lieu of additional full plansets, a copy of this approval letter and index sheet shall be attached to
plans that correspond with the copy on file with the Department. All permits required by the state or the local
municipality shall be obtained prior to connnencement of construction/installation/operation. If this construction
project will disturb one or more acres ofjand, an Erosion Control Notice ofIntent (Nor) shall be filed with the
department 14 days prior to any earth disturbing activities.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise makiug them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
JEFFREY OLENICZAK
Page 2
11/18/2005
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely,
Fee Reqnired $
Fee Received $
Balance Due $
300.00
300.00
0.00
Lynne M LeCoumt
Engineering Consultant Integrated Services
Fire Protection and Commercial
(920)492-7727, MTRF 6:30 am- 4:00pm, W 7 am-II am
llecoumt@commerce.state.wi.us
cc: Peter R Gchs, Building Inspector, (920) 948-3500 , Friday, 7:45 A.M. - 4:30 P.M.
Monroe Equipment Inc
Andy Dwnke, Dwnke Management
ÁiÞ" commerce.wi.gov
~ 1!!a9Jt!l!:!
Safety and Buildings
2331 SAN LUIS PL STE 150
GREEN BAY WI 64304
TDD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
January 11,2006
CUST lD No. 260804
ATTN: Buildings & Structures Inspector
STEPHEN GRIES
GRIES ARCHITECTURAL GROUP INC
500 N COMMERCIAL ST
NEENAH WI 54956
BUILDING INSPECTION
CITY OF OSHKOSH
POB 1130
OSHKOSH WI 54902
COMPONENTRECEnŒD
SITE:
The Animal Hospital of Oshkosh
1961 S. Washbum and 20TH Avenue
City of Oshkosh
FOR:
Object Type: Truss, Roof Regulated Object lD No.: 1057813
The department has received the above component pI';" indicated as being reviewed for compliance with the general
design concept and submitted by the building designer named above. The Department has filed the plans and other
related documents.
The department will rely on, and hold responsible, the building design professional and/or supervising professional
of record for compliance with the rules. The responsible professional should particularly insure that proper loads
and fITe resistive rating have been incorporated to correspond to the building design. Particularly insure: proper dead
and live loading, including snow drift loading increases, unbalanced loads, equipment loads, proper
bearing/supports, concentrated loads etc, are properly conveyed to foundations; and that required fITe ratings have
been employed.
The submitted materials have not been reviewed by the Department for compliance with all applicable admiuistrative
rules. The department reserves the right to formally review the plans in the future if the department detemrines that
such a review is warranted, and to order corrective actions with respect to the outcome of that review.
A copy of the plan that is identical to the plan submitted for our file shall be available for inspection at the job
site. When the total building volume exceeds 50,000 cubic feet, the plan shall bear an indication of review that has
been signed or initialed by the building designer of record.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead. Please refer to Transaction ID No. referred to in tbe regarding line when making an inquiry or
submitting additional information.
. In e:eneral ALL component plans should be sent to the Madison
office. P.O. Box 7162 Madison 53707-7162 for processine:. unless
specifically indicated otherwise on the buildine: plan review letter.
STEPHEN GRIES
Sincerely,
Vicky Brennan
Customer Service Representative, Integrated Services
(920) 492-5601, Fax: (920) 492-5604, Mon. - Fri. 8:00 a.ill. - 3:00 p.m.
vbrennan@connnerce.state.wi.us
Page 2
1/11/2006
Fee Required $
Fee Received $
Balance Due $
100.00
100.00
0.00
cc: Peter R Ochs, Building Inspector, (920) 948-3500 , Friday, 7:45 A.M. - 4:30 P.M.
~
CORRECTION NOTICE / FIELD INSPECTION REPORT
JOBUKATION, ~~ ~~~~~~
CONTRACTOR: I... ~
PROJECTTOBEINSPECTED( ~ c'J-¿¿/(
TYPE OF INSPECTION:
~
City of Oshkosh
Inspection Services Division
215 Church Avenue, PO Box 1130
Oshkosh, Wt 54903-1130
Phone: (920) 236-5050
Fax (920) 236-5084
Violations must be corrected and approved within 30 days unless otherwise noted. Call for re-inspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent must sign and date at the bottom ofthis notice
and return it to the Inspection Services Division by the Compliance Date of
. -~iC.O:øE INSPECDONRESULTS
0 MailedlFaxed
Print Name
Company
Signature:
Date
Page 1 of2
Dannhoff, Allyn J.
From: Jay Johnson [jjohnson@griesarchitectural.com]
Sent: Monday, October 17, 2005 12:28 PM
To: Kevin Duffy
Cc: Allyn Dannhoff
Subject: Fw: The Animal Hospital of Oshkosh
Kevin,
Piease forward the following info to the Job Foreman Jef at the Animal Hospital Job Site.
This was one issue brought up by the inspector on the walk-thru rough framing inspection.
The spiice plate at the front vestibule microlam shouid consist of the following.
Remove currant spiice plate and install per structural engineers notes below.
Please call wi any questions or concerns.
Thanks
Jay Johnson
Gries Architectural Group Inc.
----- Original Message -----
From: Brian Endter
To: Jay Johns_on
Sent: Friday, October 14, 2005 3:55 PM
Subject: The Animal Hospital of Oshkosh
Jay,
To "splice" the wood plates back together where they are interupted by
the H-2 beams (two locations on the end wall), I propose to use Simpson
MSTC28 Strap Tie with (12) 10d x 1 1/2" nails on each side of the
interuption in wood plates (24 nails per strap tie total).
Thank you
Brian Endter
Project Engineer
bendter@larsonwi.com
Larson Engineering of Wise on sin
1500 Casaloma Drive, Suite 302
Appleton, Wisconsin 54913 - 8219 USA
T 920.734.9867 F 920.734.9880
10/17/05
~
krf'¡¿
CORRECTION NOTICE I FIELD INSPECTION REPORT ~
JOB LOCATION: 1'7~1 ..r. ¿dk,.../ziur-rl ;)tf--
CONTRACTOR: ~ v<- 0/-£'( ý'-'
PROJECT TO BE INSPECTED: /J ..-/-../ ~;f:>I' '¡~I
TYPE OF INSPECTION: ;::;'" - /
City of Oshkosh
Inspection Services Division
215 Church Avenue, PO Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax (920) 236-5084
Violations must be corrected and approved within 30 days unless otherwise noted. Call for re-inspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent must sign and date at the bottom of this notice
and return it to the Inspection Services Division by the Compliance Date of
INSPECTION RESULTS
Print Name
Company
Signature:
Date
~
f>-'\ ¿f}-f' ¿
CORRECTION NOTICE / FIELD INSPECTION REPÒRT ~
JOB LOCATION: 1'1~ I .s. t<OlfJ h b <J-r- to?
City of Oshkosh
Inspection Services Division
215 Church Avenue, PO Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax (920) 236-5084
CONTRACTOR:
PROJECT TO BE INSPECTED:
TYPE OF INSPECTION: Pr\~
Violations must be corrected and approved within 30 days unless otherwise noted. Call for re-inspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent must sign and date at the bottom of this notice
and return it to the Inspection Services Division by the Compliance Date of
# " INSPECTIONR)l:SULTS
IO~
0 MailedIFaxed
Print Name
Company
Signature:
Date
01-119/2606 12:00 FAX
9207316386
Christensen Htg
~ 002/002
(~.\LI~-'l~J:~..I I~~\----t;:¡
¡~,C'I "-c- \-\("/~f'1!'-'-
BUILDINGS, HV AC, COMPLIANCE STATEMENT SBD-9720
This form 15 required to be submitted by the supervising professional (arohiteot, engineer, HVAC designer or electrical
designer) observing construction of projects within buildings with total areas 50,000 cubic feet or greater and bleachers
¡Comm 50 10lComm 61.50). Failure to subm~ this form may result In penalties as specified in Comm SO.26/Comm 61 23
and/or local ordinances. This form must be submitted prior to the plan approval expiration date or anolher subm,nal may
be required.
General Instructions; Prior to the initial occupancy of new buildings or additions and the final occupancy of
aitered existing buildings. subm~ this completed and signed form to:
. The municipal building inspection office and
. Safety and Buildings, 10541N Ranch Road Hayward, Wi. 54843
Note: If the review was done by the municipality. the compliance statement goes only to the municipal building
inspector. A copy is not needed by safety & Buildings.
Porsonai mrorma~on you provide may b. usad for se""ndary purposes [Privacy Low, s, 15.04 I' )1m))
1. PROJECT1Nf0RMATION: ~.fitHn lI1e fo*owing-wlth'irrr-ormatron frcm-)lo.r plan appfov<ri-I'e~er
TransactiOn 10 NumPer i'l.oð'?:>11"L>
Site Number ,01 \ I'::>
Site location (number & street) \q"" I "5. 'W~""'l-\e:,.j~
5õ'Clty 0 Village 0 Town of O?\..\~\-\ County of b\.\,.J,..J~~(...,o
2. PURPOSE OF THIS STATEMENT: (Check Box A, B, C, or 0 to indicate purpose and complete any other
applicable boxes and information. Attach add~ional pages If necessary.)
Check thOse Which apply: C1 Building Object ID # B"HVAC Object 10 # \Mløl.O \9
0 Lighting Object ID#
0 Partial Completion
Oescripoon of I'o~on Complatad
A) r;;rr Statement of Substantial Compliance
To the host of my knowledge. belief, and hased on onsile observation, construc,on of the following building andlo' HVAC
ita"", .pplioa~lato this project have ~..n completed In substantial oomplianoa with the approved plans and
specifioations.
0 BUILDING/LIGHTING ITEMS
I. $1nJCIU131 .."em inoludln~ sUbmltlaland .",cdon of ell building compon.nts
¡trusses. pre""e', m.ta' building, etc.)
2. Fire pmlec~on syotems {sprinkle". ala",,', .moke delecloro) de,ignad.
Ins,alled, and te..ad (Including rorMIrO Oowon back Oowdevlce,) by
approprietel. registered professionals
3. Shaft and "airway enclooure
~ Ex'" Including exll and dl...otional ,;gnts
5. Flre-",sls'lve con.lruclion, enclosure 0' haZards, fire .....110. labeled doo,", cl"", õt"HVAC ITEMS
or conslNclion, fi... stopped peo<t,.lIo",
6. sanit.llon system ('oileCO, "nk., drtnklng facilities)
7 Bamer-'",e includin~ Comm 18 olavat.", and lifts
s. Ener.. envelope ",qulrements
9, All condõtlons .f building plan epprDva' and .pplioabio YOrtan«<
The following Items aro not In complIance and must ho addressed:
10 EXlerlo, "Intlnl & '00"01 rooelro",.n..
II InI,oorlighUnl&conl",lreq...r.",oolS
12. AU ,ond'loon. of "Inting .I,n a.,.ov,1
'0; applic'ble YOhanco.
1. HvAC 'YOlem Ineledlng final"st
2. All eoOdltlons of HVAC plan .,.rov,1 'M
...licabl. <,nanc..
B) 0 Statement of Noncompliance
D"e 10 the 'allowIng listed violation" 'hi, proj""t Is not ready ror eccup'ncy:
C) 0 Supervising Professional Withdrawn From Project (U.. A 01 B abov, \0 Indicate "olect ,"'us as of Ih,. dale)
OJ (] Project Abandoned
3. SUPERViSING PROFESSIONAL SIGNATURE FOR:
0 Build,n. &rHVAC 0 Ught;ng~~ ~- O~l<:...~
N,me (,lease print or type)
Pnon- numben....'l.-'~.~ .!JIC\O Cu,lom_r IPj/ \r¡iJ...-4-'2.F"-;.
SBD-9TIO (R.Ú2l2004)
Buildings, HV AC Compliance Statement SBD-9720
This form is required to be submitted by the supervising professional (architect. engineer, HVAC designer or electrical
designer) observing construction of projects within buildings with total areas exceeding 50,000 cubic feet or greater and
bleachers (Comm 50.1 O/Comm 61.50). Failure to submit this form may result in penalties as specified in Comm 50.26/Comm
61.23 and/or local ordinances.
General Instructions: Prior to the initial occupancy of new buildings or additions and the final ~~K ~f I. E D
altered existing buildings, submit this completed and signed form to: RE \,... r: I V
. The municipal building inspection office and
. Safety and Buildings, 10541 N Ranch Road, Hayward, WI 54843
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1)(m)]. JAN 1 9 2006
1. PROJECT INFORMATION: Please fill in the following with information from your plan approvß~p1þ,~rMENT OF
Transaction ID Number 1151715 eOMMUI'IITV )EVELOPMEt4r
Site Number 701113
Site location (number & street) 1961 S. Washburn
0 City 0 Village 0 Town Of Oshkosh County of Winnebago
2. PURPOSE OF THIS STATEMENT: (Check Box A, B, C, or D to indicate purpose and complete any other
applicable boxes and information. Attach additional pages if necessary).
Check those which apply: 0 Building Object ID# 1057813
0 Lighting Object ID#
0 HVAC Object ID#
0 Partial Completion
Description of Portion Completed
A) 0 Statement of Substantial Compliance
To the best of my knowledge, belief, and based on onsite observation, construction of the following building and/or HVAC items
appiicable to this project have been completed in substantial compliance with the approved plans and specifications.
0 BUILDINGILIGHTING ITEMS
1. Structural system including submittal and erection of all building
components (trusses, precast. metal building, etc.)
2. Fire protection systems (sprinklers, alarms, smoke detectors)
designed, installed, and tested (including forward flow on back flow
devices) by appropriately registered professionals.
3. Shalt and stairway enclosure
4. Exits including exit and directional lights
5. Fire-resistive construction, enclosure of hazards, fire walls. labeled
doors, olass of construction, fire stopped penetrations
6. Sanitation system (toilets, sinks, drinking facilities)
7. Barrier-free including Comm 18 elevators and lifts
8. Energy envelope requirements
9. All eanditions of building plan approval and applicable variances
The following items are not in compliance and must be addressed:
10. Exterior iighting & control requirements
11. Interior lighting & control requirements
12. All conditions of lighting plan approval
and applicable variances
0 HVACITEMS
1. HV AC system including final test
2. All conditions of HVAC plan approval
and applicable variances
B) 0 Statement of Noncompliance
Due to the following iisted violations, this project is not ready for occupancy:
C) 0 Supervising Professional Withdrawn From Project (Use A or B above to indicate project status as of this date.)
D) 0 Project Abandoned
3. SUPERVISING PROFESSIONAL SIGNATURE FOR:
0 Building 0 HVAC 0 Lighting Ste hen Gries
Name (please print or type)
Customer ID# 260804 Signature
Phone #
920-722-2445
SBD-9720 (R.0l12003)
1/17/2006
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