HomeMy WebLinkAboutCertificate of Occupancy
~ CITY HALL
Inspection Services Div
215 Church Avenue
~POBOX1130
Oshkosh WI
~ 54903-1130_
OfHKOfH
ON THE WATER
City of Oshkosh
Approved:
Issued:
01/22/2007
02/01/2007
STARBUCKS
240 W MURDOCK AVE
OSHKOSH WI 54901
CERTIFICATE OF OCCUPANCY
An Occupancy Permit is hereby issued for the Coffee Shop/Restaurant located at
240 W Murdock Ave as described in Permit #121754.
This office space is to be used as a Coffee Shop/Restaurant and is located in the
C-2 General Commercial District.
LIMITATIONS:
Maximum number of persons: 38
Certificate of Occupancy shall be req4ired 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 certificate to be valid.
DIRE
cc: Creative Constructors LLC
"
Building Permit Work Card
. ,
Job Address 210-240 W MURDOCK AVE Permit Number 0121754 Create Date 9/27/2006
Owner BRADLEY OPERATING L TD PARTNERSHIP Contractor CREATIVE CONSTRUCTORS LLC
Category 232 - Alteration Stores & Customer Service Plan V5-95-0906
Occupany Permit Required Flood Plain No Height Permit Not Required Class of Const: 2B
Use/Nature ~40 W Murdock Avel Tenant space build out for "Starbucks Coffee" as per State Plan ApproavllD # 1289056
of Work
HV AC Contr UNKNOWN??? Plumbing Contr BRADEN PLUMBING INC. ...
Electric Contr JACK'S ELECTRIC INC
Inspections:
Date 2/1/2007 Type Inspector Allyn Dannhoff
pccupancy approved - signed compliance statement and correction notice was received.
approved
DatelTime requested:
Access: I
Requested By:
o Reinspect Fee 0 Fee Waived
Notice Type:
Ready DatelTime:
Phone Number:
D Reinspect Fee Paid
Page 2 of 2
. Building Permit Work Card
Job Address 210:240 W MURDOCK AVE Permit Number 0121754 Create Date 9/27/2006
Owner BRADLEY OPERATING L TD PARTNERSHIP Contractor CREATIVE CONSTRUCTORS LLC
Category 232 - Alteration Stores & Customer Service Plan V5-95-0906
Occupany Permit Required Flood Plain No Height Permit Not Required Class of Const: 2B
Use/Nature 1240 W Murdock Ave/ Tenant space build out for "Starbucks Coffee" as per State Plan ApproavllD # 1289056
of Work
HVAC Contr UNKNOWN??? Plumbing Contr BRADEN PLUMBING INC. __ _ .
Electric Contr JACK'S ELECTRIC INC
Inspections:
Date 10/25/2006 Type Rough In Inspector Allyn Dannhoff
rhellrr e"."!box only - See FeN.
DatelTime requested: Notice Type: Ready DatelTime:
Access: I
Requested By: Phone Number:
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
not approved
Date 12/5/2006 : AM Type Re Rough In Inspector Allyn Dannhoff
Request Line / Ready for a framing inspection. No concerns noted.
approved
DatelTime requested: 12/1/2006 02:02 PM Notice Type:
Access: ~i11 be open from 7am-3:30pm on Monday 12-4-06
Requested By: CREATIVE CONSTRUCTORS LLC - Andy
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Ready DatelTime: 12/4/2006 00:00
Phone Number: (414) 531-3695
Date 1/4/2007 : AM Type Rough In Inspector Allyn Dannhoff
Request line/ Above ceiling inspection. Would like this done by Friday PM Jan. 5. 1/4/07 - No concerns noted.
approved
DatelTime requested: 1/3/2007 09:56 AM Notice Type:
Access: IOpen 7:30 to 2:00
Requested By: CREATIVE CONSTRUCTORS LLC - Andy
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Ready DatelTime: 1/3/2007 09:56
Phone Number: 414-531-3695
Date 1/19/2007 : AM Type Final Inspector Allyn Dannhoff not approved
Request line/ Will be there between 8:00 and noon. 1/19/07 - Post a note at HVAC S.D. alarm indicating what the alarm signifies;
provide 8/H Compliance Satements; secure electric/plumbing approval. Correction Notice sent.
DatelTime requested: 1/16/2007 09:59 AM Notice Type:
Access: I
Requested By: CREATIVE CONSTRUCTORS LLC - Andy
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Ready DatelTilT1e: 1/18/2007 AM
Phone Number: 414-531-3695
Page 1 of 2
HVAC Permit Work Card
Job Address 210-240 W MURDOCK AVE Permit Number 122870 Create Date 09/27/2006
Owner BRADLEY OPERATING LTD PARTNERSH Contractor CENTRAL HEATING SERVICEINC
Fuel ~ Gas I U Oil I ~ Electric I U Solar U Solid I Value $4,200.00
System 0 New I D Replace I D Other I
~ Forced Air U Radiant I U Steam I ~ A1C I U Vent I
U Electric I U Hot Water I U Suppl. I U Con. Burner I
Chimney Type 0 Chimney A 0 Chimney B 0 Direct Vent . Not Applicable
Use/Nature 40 W Murdock Ave / Install registers/grills and flex duct to complete the tenant space build out for "Starbucks Coffee" as per State
of Work Plan ApproavllD # 1289056. * Note: Main Trunks installed under permit 122554, general HVAC permit for the entire mall.
!
Inspections:
Date 1/19/2007 Type Final Inspector Allyn Dannhoff not approved
iSee FCN - Post a note at HVAC S.D. alarm indicating what the alarm signifies; provide 8/H Compliance Statements; secure
electric/plumbing approval. Correction Notice sent.
DatelTime requested:
Access: I
Requested By:
o Reinspect Fee 0 Fee Waived
Notice Type:
Ready DatelTime:
Phone Number:
D Reinspect Fee Paid
Date 2/1/2007
Type Final Inspector Allyn Dannhoff approved
r'9,ed Complla,,,,, Slateme" a"" Coneellon Nell"" wo, <e<elved. O",'p,"cy appro""".
DatelTime requested:
Access: I
Requested By:
o Reinspect Fee 0 Fee Waived
Notice Type:
Ready DatelTime:
Phone Number:
D Reinspect Fee Paid
- - - - - '- - - - - - - - - -- - - - - -- - - -..- - -- - - - - - - - - -- - - - - - - - - --- - - - - - - -- - - - - -- - - - - - -- - - - - - - - -- - - - - - - - - - --- - - - - - - -- - - - - - - - - - - - - - --..; - -- - - -;.- - - - - - -- - -,-'- - - --- - - - - - -'-- - - - - - - - - - - - - - -- - - - -- - - - --
J L' 'r' Electric Permit Work Card
Job Address 210-240 W MURDOCK AVE Permit Number 121959
Create Date 9/27/2006
Owner BRADLEY OPERATING LTD PARTNERSHIP Contractor JACK'S ELECTRIC INC
Service b New 0 ChangeO Temp . N/A I Type 0 Overhead 0 Underground. N/A
Volts 120/208 Circuits 43 Luminaires 95
Amps 400 Switches 11 Receptacles 55
U,eJNalu", 642 - Comme""a,New .,"d"9 ""'9 240 W Mu","'" Awl T '"'""""" build out to< .SIa",""" Coffee. '" ...- Sla'e I
of Work Plan ApproavllD # 1289056
Value
$25,000.00
Inspections:
Date 01/23/2007 Type Re Final Inspector Kevin Benner
Would be ready in the late PM
I disconnecting means shall be installed for the Drive-thru signs.
Faxed to the the E.C. 1/24/07
approved w/cond.
]
DatelTime requested: 01/22/2007 12:21 PM
Access:
Notice Type:
Ready DatelTime: 01/22/200703:00 PM
Requested by: JACK'S ELECTRIC INC
o Reinspect Fee 0 Fee Wavied D Reinspect Fee Paid
Phone Number:
Electric Permit Work Card
. .
Job Address 210-240 W MURDOCK AVE
....~~,
Permit Number 121959
Create Date 9/27/2006
Owner BRADLEY OPERATING L TD PARTNERSHIP Contractor JACK'S ELECTRIC INC
Service b New 0 ChangeO Temp . N/A I Type 0 Overhead 0 Underground. N/A
Volts 120/208 Circuits 43 Luminaires 95
Amps 400 Switches 11 Receptacles 55
U_atu", 1142 - Commecd.I-New Build',. Wlri,. 240 W M,",ook A"'" T e",,"p''''' b,lId ,,!fa.- .Slam"," Coffee" " ...- Slate I
of Work Plan ApproavllD # 1289056
Value
$25,000.00
Inspections:
. Date 10/24/2006 Type Rough In Inspector Adam Krause approved
REQUEST LINE I READY FOR A ROUGH INSPECnON IF YOU CANNOT COME THIS AFTERNOON OR TOMORROW PLEASE CALL .1
DatelTime requested: 10/24/2006 12:54 PM
Access:
Requested by: JACK'S ELECTRIC INC
o Reinspect Fee 0 Fee Wavied D Reinspect Fee Paid
Notice Type:
Ready DatelTime: 10/24/200612:54 PM
Phone Number: (920) 733-1591
Date 12/04/2006 Type Rough In Inspector Kevin Benner
REQUEST LINE / Ready for a rough inspection - Monday afternoon 12-4-06
Reviewed with the electrician on site to secure 3 3/4" raceways on the west wall by the drive-up window.
approved w/cond.
J
DatelTime requested: 12/01/2006 09:54 AM
Access: Electrician wil be on site
Requested by: JACK'S ELECTRIC INC
o Reinspect Fee 0 Fee Wavied D Reinspect Fee Paid
Notice Type:
Ready DatelThne: 12/04/200600:00 PM
Phone Number: (920) 733-1591
Date 01/03/2007
Type Abv Ceiling
Inspector Kevin Benner
approved w/cond.
Request line
Open j-box for the bathroom exhaust fan relay and work space requirement for the lighting contactor in the ceiling above the electrical
panel. Discussed w/ Jim making the ceiling main removeable by the contactor.
DatelTime requested: 01/02/2007 11 :24 AM
Access:
Notice Type:
Ready DatelTime: 01/03/2007
PM
Requested by: JACK'S ELECTRIC INC - Jack
o Reinspect Fee 0 Fee Wavied D Reinspect Fee Paid
Phone Number: 920-733-1591
Date 01/17/2007
req...."'''''
DatelTime requested: 01/16/2007 09:37 AM
Access: Open
Type Final
Inspector Kevin Benner
not approved
]
Notice Type: FC Ready DatelTime: 01/17/2007
PM
Requested by: JACK'S ELECTRIC INC
o Reinspect Fee 0 Fee Wavied D Reinspect Fee Paid
Phone Number: 920-733-1591
Inspections for Work Card 88082
Date 9/13/2006 Type Underground Inspector Paul Wolf
approved w/cond.
Fax request/Finally have state approved plbg plan on site. We won't be on site but can meet you if need be. Most work has been backfilled. Went over
pproved plumbing drawing on-site with underground.
DatelTime requested: 9/13/200610:16 AM Notice Type: Telephone Number: Jeff-757-5258
Access: I
. Ready DatelTime: 9/13/2006 08:00 AM Requested By: JIM'S PLUMBING &HEATINGINC
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Date 1/22/2007 ,Type Re Final
Inspector Rich Wood
not approved
DOOR LOCKED AND NO KEY IN THE LOCK BOX HANGING ON THE HANDLECALLED JIM'S PLUMBING RE: ACCESS
DatelTime requested: 1/22/200702:28 PM Notice Type:
Access: I
Ready DatelTime: 1/22/2007 02:28 PM Requested By:
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Telephone Number:
Date 1/24/2007
Type Re Final
Inspector Rich Wood
not approved
DatelTime requested: 1/24/200708:57 AM Notice Type:
Access: ~NDY AND OWNER WILL BE ON SITE AT NOON TODAY
Ready DatelTime: 1/24/2007 12:00 PM Requested By: ANDY
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Telephone Number: 414-531-3695
Date 1/29/2007
Type Re Final
Inspector Rich Wood
approved
DatelTime requested: 2/1/2007 07:25 AM Notice Type:
Access: I
Ready DatelTime: 1/29/2007 09:00 AM Requested By:
o Reinspect Fee 0 Fee Waived D Reinspect Fee Paid
Telephone Number:
Plumbing Permit Work Card
Permit Number 121233
Contractor JIM'S PLUMBING & HEATING INC
Plan G2-207-0706-P
_ Shamp Sink
Flr/Wst Sink
Catch Basin
-
1 Wash Ftn
2 Urinal
~_~t<!ndp Rec..
_ Ice Maker
_ Gar Drain
--1 Soda Disp
Job Address 210-240 W MURDOCK AVE
Owner BRADLEY OPERATING liMITED PARTNEF
Category 440 - Industrial-Interior
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar.Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
......
Sanitary Sewer
Storm Sewer
Water Service
Shower Water Softner Wait. St.
- - -
Floor Drain 4 Local Waste Ice Chest
- - -
2 Lndry Tray Clothes Wshr Exam Sink
- -
2 Disposal - Bidet Sculry Sink
- -
- Dishwasher - Beer Tap Hand Sink
-
Sump Pump - La!) Sink. .......' _"_.0"_ ..Pl<!~t~r..Sink.
- Classrm Sink - Sterilizer - Surgeons Sink
- Breakrm Sink - Dip Well - F Prep Sink
- Ejector/Grind - Drink Ftn - Serv Sink
-
Create Date 08/18/2006
Value
$4,250.00
- Coffee Maker
-
3 Int Grease Trap 1
- -
- Ext Grease Trap -
- RPZ Valve -
- Eye Wash Statn -
-"'. . 'Ntr Sewer Mtrs ~
- Deduct Meters -
- Wtr Usage Mtrs -
-
NEW STRIP MALU INTERIOR PLUMBING FOR NEW STARBUCKS AT240 W MURDOCK .*debit acct
Size
Material
Type
#
Conn.Type
:
.. ~ commerce.wi.gov
'W!!E.9f1c!!Q
Safety and Buildings
10541 N RANCH ROAD
HAYWARD WI 54843
mD #: (608) 264-8777
www.commerce.wi.gov/sb/
www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
August 04, 2006
CUST ID No. 647891
ATTN: Buildings & Strnctures Inspector
GEORGESARFATTY
SARFATTY ASSOCIATES
3201 OLD GLENVIEW RD STE 301
WILMETTE IL 60091
BUILDING INSPECTION
CITY OF OSHKOSH
POB 1130
OSHKOSH WI 54902
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/04/2007
Identification Numbers
Transaction ID No. 1289056
Site ID No. 713262
Please refer to both identification numbers,
above, in all corres ondence with the a enc .
SITE:
Fair Acres Shopping Centre
Jackson Street
City of Oshkosh, 54901
FOR:
Facility: 674909 FAIR ACRES SHOPPING CENTRE STARBUCKS
1900 JACKSON STREET
OSHKOSH 54901
'0
Object Type: Building ICC Regulated Object ID No.: 1086062
Major Occupancy: Assembly; Type 1m Metal Frame Unprotected class of construction; Addition-Alteration plan;
1,712 project sq ft; Unsprink1ered; Occupancy: A-2 Dining & Drinking; Component(s) submitted with this transaction:
Lighting, HV AC ICC; Allowable area determined by: Unseparated Use
.Object Type: HV AC ICC System Regulated Object ID No.: 1086063
1,712 sq ftArea Heated
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal hils been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. This review is
for a tenant build-out in a previously reviewed five unit building shell on an outlot at the Fair Acres site.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Key Item(s)
. IECC 803.2.6 & 803.3.3.5/Comm 63.1031 Provide an economizer cycle for the cooling system unless the
designer can demonstrate that one of the exceptions in the code can be met.
Also Address
. mc 1003.2.3.1 Door encroachment is not permitted to reduce the required egress width to less than one-half
during the course of the door swing. The men's restroom door must be modified. This could include installing
a ~arrower do?r that is still in accordance wit~ IB~ 1003.3.1.1, making the hallway ".E ~sE'1V' ED
Wider, or makmg the men's restroom door swmg mward. ~ .' ~ ..
Reminders AUG 07 2006
. IMC 313/Comm 64.0313(3) All operating manuals concerning the HV AC equipment and its maintenance
shall be presented to the owner. DEPARTMENT OF
COMMUNITY DEVELOPMENT
..)
GEORGE SARF A TTY
Page 2
8/4/2006
. IMC 313/Comm 64.0313(1) HVAC system balancing shall be performed, and a report shall be made available
to a Department representative upon request.
. IMC 307.2.1/IFGC 307.2.1 Provide a means to convey condensate from cooling coils and evaporators from a
drain pan outlet to an approved place of disposal. Discharge into a street, alley or other areas of nuisance are
not allowed.
. Approval of Plumbing Plans is not included with this review. Submittal of Plumbing Plans and Calculations in
compliance with mc 2901.1 and Comm 81 to 87 may be required depending on the number of fixtures and
type of facility. Approval of Plumbing Plans, if required, shall be obtained prior to commencing construction:
. Comm 61.31(2)(b) A copy of this approval letter and index sheet shaU be attached to plans that correspond
with the copy on file with the Department. Changes to the approved plan must be submitted for review and
approval. Failure to properly attach the approval and index page to plans that match the copy on file with the
Department may result in enforcement action under ss. 10 1.02 or 443.13, Statutes.
A copy of the approved plans, specifications and this letter shall be em-site during construction and open to
\ inspection by authorized :representatives of the Department, which may include local inspectors. If plan 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 commencement of construction/installation/operation. If this construction
project will disturb one or more acres ofland, an Erosion Control Notice ofIntent (NOI) 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 making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall,relievethe designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Fee Required $
Fee Received $
Balance Due $
450.00
450.00
0.00
Sincerely,
~" ,.
~~
Ra, ~ B. Mattison, P .E.
Builaing Plan Reviewer, Integrated Services ,
(715) 634-8964, Fax: (715) 634-5150, Mon & Fri 7:30 am- 5:00 pm
randall.mattison@wisconsin.gov
Wi SMART code: 7648
cc: Peter R Ochs, State Building Inspector, (920) 948-3500, Friday, 7:45 A.M. - 4:30 P.M.
Andrew White, Heritage Realty .
e
OSHKOSH
ON THE WATER
Issue Date 1/23/2007
Address 210-240 W MURDOCK AVE
Name Address
I BRADLEY OPERATING LTD PARTNERS 131 DARTMOUTH ST
INSPECTION SERVICES DIVISION ROOM 205
DEPARTMENT OF COMMUNITY DEVELOPMENT
CORRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
PO Box 1130
OSHKOSH WI 54903-1130
Compliance Date 2/22/2007 IMMEDIATELY
Compliance No
City
BOSTON
State Zip Code
MA 2116 -5134
Sent to
~ Owner
Introduction
U Required for Occupancy Occupancy
Occupancy Inspection of Starbucks on 1/19/07 revealed the following items to correct/complete.
,
Item # Code State Compliance No Compliance Date 02/22/2007 IMMEDIATELY
Description Comm 61.50(4) The Supervising Professionals shall submit Building, Lighting and HVAC Compliance Statements.
01/23/2007
Last
Updated
Item # 2 Code State Compliance Compliance Date 02/22/2007 IMMEDIATELY
Description ~OMM 62.1003.2.2.5 Every room that is an Assembly Occupancy shall have a sign posted in a conspicuous place stating the maximum
pccupancy. These signs shall be a "graviply" style sign with 1-1/2" white letters and 3" white numbers on a dark background.
01/23/2007
Last
Updated
,
Item # 3 Code State Compliance No Compliance Date 02/22/2007 IMMEDIATELY
Description Comm 64.0606.4.1 Exception 2 - Provide a sign at the HV AC Duct Alarm indicating the difference in alarms between Air Duct Detector
ctivation and an Air Duct Detector Trouble condition.
01/23/2007,
Last
Updated
12200
Page 1 of2
e
OSHKOSH
ON THE WATER
Issue Date 1/23/2007
Address 210-240 W MURDOCK AVE
Name Address
I BRADLEY OPERATINGLTD PARTNERS 131 DARTMOUTH ST
INSPECTION SERVICES DIVISION ROOM 205
DEPARTMENT OF COMMUNITY DEVELOPMENT
CORRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
PO Box 1130
OSHKOSH WI 54903-1130
Compliance Date 2/22/2007 IMMEDIATELY
Compliance No
Sent to
~ Owner
City
BOSTON
State Zip Code
MA 2116 -5134
Introduction
Occupancy Inspection of Starbucks on 1/19/07 revealed the following items to correct/complete.
U Required for Occupancy
Occupancy
Item # 4 Code 7-31 Compliance Not Checked Compliance Date 02/22/2007 IMMEDIATELY
Description Secure Electric and Plumbing Approval. Make arrangements with the inspector to provide access for the required reinspections.
01/23/2007
Last
Updated
i
hen all items are complete, the person(s) responsible shall sign, date, and return a copy of this notice signifying such
mpliance (see end of this notice.) Occupancy is not approved until all items in this notice have been corrected.
Summary
Violations must be corrected and approved within 30 days unless otherwise noted. Call for reinspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent mus~ sign and date at the bottom of this notice
and return it to the Inspection Services Division by the Compliance Date of 2/22/2007
Office hours' for obtain'ing permits are Monday through Friday 7:30-8:30 a.m. and 12:30-1 :30 p.m. or by appointment. To schedule
inspections please call the Inspection Request line at 236-5128 noting the address, permit number (when applicable), and the
nature "what ~ to be ;nspected.
Signature ttt2.. Date
Inspected by: Allyn Dannhoff 236-5045 adannhoff@ci.oshkosh.wi.us
I hereby certify the violations listed on this report have been corrected in compliance with the applicable codes.
Print Name
Company
Signature
Date
Also Sent to: ~ Bldg
U Elec
~ HVAC
U Plbg
U Designer
~ Other
U Inspector
CREATIVE CONSTRUCTORS LLC
N83 W13430 LEON RD
MENOMINEE F WI 53051 .3306
CENTRAL HEATING SERVICE INC
1565 HARRISON STREET
OSHKOSH
WI 54901 -0
SARFATTY ASSOCIATES
3201 OLD GLENVIEW RD STE 301
WILMETTE
IL 60091-
12200
Page 2 of 2
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 area9 50,000 cubic feet or greater and bleachers
(Comm 50.10/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. This form must be submitted prior to the plan approval expiration date or another submittal may
be required. '
General Instructions: Prior to the initial occupancy of new buildings or additions and the final occupancy of
altered existing buildings, submit this completed and signed form to:
· The municipal building inspection office and
· Safety and Buildings, 10541 N 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.
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1)(m)].
1. PROJECT INFORMATION: Please fill in the following with information from your plan approval letter.
Transaction 10 Number I :l~C1OS(P
Site Number 1 t 3 2. 0 2-
Site location (number & 'street) :;.1..( 0 H, NvRt>co:::.
~ity 0 Village 0 Town of C)-:;~ICOS.+( County of Hlt4~1~~/oO
2. PURPOSE OF THIS STATEMENT: (Check Box A, B, C, or 0 to indicate purpose and complete any other
applicable boxes and information. Attach additional pages if necessary.) ,
Check those which apply: .d1'Building Object 10 # rO~<ODCo<'2..erHVAC Object 10 # 1()~ocYo,
o Lighting Object 10 #
o Partial Completion
Description of Portion Completed
A) ~ 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 applicable to this project have been completed in substantial compliance with the approved plans and
specifications.
.11' BUILDING/LlGHTING 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. Shaft and stairway enclosure
4. Exits including exit and directional lights
5. Fire-resistive construction, enclosure of hazards, fire walls, labeled doors, class
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 conditions of building plan approval and applicable variances
10. Exterior lighting & control requirements
11. Interior lighting & control requirements
12. All conditions of lighting plan approval
and applicable variances
~HVAC ITEMS
1. HV AC system including final test
2. All conditions of HVAC plan approval and
applicable variances
The following items are not in compliance and must be addressed:
B) 0 Statement of Noncompliance
Due to the following listed 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:
ZBuilding ;;t'HVAC 0 Lighting ((j'f!s()~b&" SA~PA l<1Y
Name (please print or type)
Phone number ~ -, -9':1D-IIDOCustomer ID # (04 ") cP~ (
Date
\/,)Yic:>,
Signature
~
SBD-9720 (R.02/2004)
.-
OSHKOSH
ON THE WATER
Issue Date 1/23/2007
Address 210-240 W MURDOCK AVE
Name Address
BRADLEY OPERATING LTD PARTNERS 131 DARTMOUTH ST
Sent to
INSPECTION SERVICES DIVISION ROOM 205
DEPARTMENT OF COMMUNITY DEVELOPMENT
CORRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
PO Box 1130
OSHKOSH WI 54903-1130
Compliance Date 2/22/2007 IMMEDIATELY
Compliance No
~ Owner
City
BOSTON
State Zip Code
MA 2116 -5134
U Required for Occupancy
Occupancy
Item # Code State Compliance No Compliance Date 02/22/2007 IMMEDIA TEL Y
Description ....omm 61.50(4) The Supervising Professionals shall submit Building, Lighting and HVAC Compliance Statements.
01/23/2007
Last
Updated
Item # 2
Description
01/23/2007
Last
Updated
Item # 3
Description
01/23/2007
Last
Updated
/
Code State Compliance,A--:S Compliance Date 02/22/2007 IMMEDIATELY
~OMM 62.1003.2.2.5 Every room that is an Assembly Occupancy shall have a sign posted in a conspicuous place stating the maximum
pccupancy. These signs shall be a "graviply" style sign with 1-1/2" white letters and 3" white numbers on a dark background.
Code State Compliance No ft-:;; Compliance Date 02/22/2007 IMMEDIATELY
Comm 64.0606.4. i Exception 2 - Provide a sign at the HVAC Duct Alarm indicating the difference in alarms between Air Duct Detector
Activation and an Air Duct Detector Trouble condition.
.; "
. ~".
12200
Page 1 of 2
e
OSHKOSH
ON THE WATER
Issue Date 1/23/2007
INSPECTION SERVICES DIVISION ROOM 205
DEPARTMENT OF COMMUNITY DEVELOPMENT
CORRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
PO Box 1130
OSHKOSH WI 54903-1130
Compliance Date 2/22/2007 IMMEDIATELY
Compliance No
Address
210-240 W MURDOCK AVE
Sent to
~ Owner
Name Address
I BRADLEY OPERATING LTD PARTNERS 131 DARTMOUTH ST
City
BOSTON
State Zip Code
MA 2116 -5134
Introduction
U Required for Occupancy Occupancy
ccupancy Inspection of Starbucks on 1/19/07 revealed the following items to correct/complete.
Item # 4 Code 7-31 Compliance Not Checked Compliance Date 02/22/2007 IMMEDIATELY
Description ~ecure Electric and Plumbing Approval. Make arrangements with the inspector to provide access for the required reinspections.
01/23/2007
Last
Updated
r
/(f"
Summary
hen all items are complete, the person(s) responsible shall sign, date, and retum a copy of this notice signifying such
compliance (see end of this notice.) Occupancy is not approved until all items in this notice have been corrected.
Violations must be corrected and approved within 30 days unless otherwise noted. Call for reinspections 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 2/22/2007
Office hours for obtaining permits are Monday through Friday 7:30-8:30 a.m. and 12:30-1 :30 p.m. or by appointment. To schedule
inspections please call the Inspection Request line at 236-5128 noting the address, permit number (when applicable), and the
nature of w~~o be insp, ected. Date/ / b"< ~7
Signature ~ ~
Inspected by: Allyn Dannhoff 236-5045 adannhoff@ci.oshkosh.wi.U5
I hereby certify the violations listed on this report have been corrected in compliance with the applicable codes.
'D1Z€-v::J.J SL' \~" &e..~~'~ ~~\-vvc.-tor<.s.
. Print ame Company
\/:S\/Z~4-
,
Date
Also Sent to: ~ Bldg
U Elec
~ HVAC
U Plbg
U Designer
~ Other
U Inspector
CREATIVE CONSTRUCTORS LLC
N83 W13430 LEON RD
MENOMINEE F WI 53051 -3306
CENTRAL HEATING SERVICE INC
1565 HARRISON STREET
OSHKOSH
WI 54901 -0
SARFATTY ASSOCIATES
3201 OLD GLENVIEW RD STE 301
WILMETTE
IL 60091-
12200
Page 2 of 2
~Feb
01 2007 12:38PM
HP LAS.ERJET FAX
F .1
FAX
3 Pages
General Contractor
Construction Manager
Date:
Fax#: 32.0 - 2...3~- SOB~
To:
"
From:
Re:
('We fire (]3uifdi1ZlJ 11
N83 W13430 Leo Road, Menomonee Falls, WI 53051
Phone: (262) 02-77.10 I Fax: (262) 502-7.7..09
vw .creativeconstructors.com
Feb 01 2007 12:38PM
HP LASER JET FAX
p.2
e
OSHKOSH
ONTl-lEWATER
Issue Date 112312007
Address 210-240 W MURDOCK AVE
Name
I BRADLEY OPERATING LTD P
INSP CTION SERVICES DMSION ROOM 205
DEPA TMENT OF COMMUNITY DEVELOPMENT
RRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
POBox 1130
OSHKOSH WI 54903-1130
Compliance Date
12007 IMMEDIATELY
Compliance No
Sent (0
~ Owner
Address
131 DARTMOUTH ST
City
BOSTON
State Zip Code
MA 2116 -5134
---
Introduction
U Required for OcaJpancy I Occupartcy
ccupancy Jnspection of Starbucks oh 1/19 7 revealed the following items to correct/complete.
Item # 1
Description
01/23/2007
Code State Compliance No Compliance Date 0212212007 IMMEDIATELY
mm 61.50(4) The Supervising Professionals she I submit Building. Ugnting and HVAC Compliance Statements.
,
Last
Updated
Item #- 2 Code State Compliance Compliance Date 02/22/2007 IMMEDIA TEL Y
Description iCOMM 62.1003.2.2.5 Every room that is an Ass bly Occupancy shall have a sign posted in a conspicuous place staling the maximum
occupancy. These signs shall be a "graviply" style ign wittl1-1J2" wtlite letters and 3- white numbers on a dark background.
01/23/2007
Last
Updated
Item # 3
Description
01/2312007
Compliance No Compliance Date 0212212007 rMMEDIATELY
e HVAC Duct Alarm indicating the difference in alarms between Air Duct Detector
Last
Updated
I
'i "":t
;t...
~~~
12200
Pag$ 1 of2
Feb 01 2007 12:38PM
HP LASERJET FAX
p.3
e.
OSHKOSH
ON THE WATER
Issue Date 1/23/2007
Addntss 21Q..240 W MURDOCK AVE
INSP CTION SERVICES DIVIS!ONROOM205
OEPA TMENT OF COMMUNITY DEVELOPMENT
ORRECTION NOTICE
CITY OF OSHKOSH
215 CHURCH AVE
PO Box 1130
OSHKOSH WI 54903-1130
Compliance Date 2J 12007 IMMEDIATELY
Compliance No
Sent to
~ Owner
Name
I BRADLEY OPERA TJNG L TO P
Address
131 DARTMOUTH ST
_ City
BOSTON
State Zip Code
MA 2116 -5134
IntrodiJc:tlon
Occupancy Inspection of Starbucks on 1/191 7 revealed the following items to correct/complete.
U Required for Occupancy ! Occupancy
Item # 4 Code 7-31
Description Secure Electric and Plumbing Approval. Make ar
01/23/2007
Compliance Not Checked Compliance Date 02122/2007 IMMEDIATELY'
gsments with the inspector to provide access for the required reinspections.
Last
Updated
Summary hen all items are complete, the person,s} sponsible shall sign, date, and return a copy of this notice signifyiT1g such
compliance (see end of this notice.) Occupa cy is not approved until all items in this notice have been corrected.
Violations must be corrected and approved within 30 days unless otherwise noted. Call for reinspectiolts priorto concealment
, and/or occupancy. Upon completing the corrections the ownerfcontractor/agent must sign and date at the bottom of this notice
and return it to the Inspection Services Division by t Compliance Date of 2/22/2007 ' ,
OffIce hours for obtaining pennits are Monday throu h Friday 7:30-8:30 8.m. and 12:30-1 :30 p.m. or by appQintment_To schedule
inspecfions please call the Inspection Request line 236-5128 noting the address, permit number (when applicable), and the
nature ofwh ds to be inspected.
Date
/~,' k7
/ '
Signature
Inspected by: Allyn Dannhoff 236-5045 adannh
I hereby certify the violations listed on this report ha'J
6 f=Q ,.J
cl.oshkosh.wLus
been corrected in compliance with the applicable codes. -
&~t.l1!.. .~.r~LJ~,
Company
2(01107
LLC-
Signature
Date
Also Sent to: l!:: Bldg
"LJ Elec
~ HVAC
U Plbg
U Designer
~ Other
U Inspector
CREATIVE CONSTRUCTORS L
NB3 W13430 LEON RD
MENOMINEE F WI 53051 -3306
CENTRAL HEATING SERVICE I
1565 HARRISON STREET
OSHKOSH
WI 54901 -0
----
SARFATTY ASSOCIATES
3201 OLD GlENVIEW RD STE 301
WILMETTE
IL 60091-
1220()
Page 2 of 2