Loading...
HomeMy WebLinkAbout2005-Certificate of Occupancy CITY HALL Inspection Services Div 215 Church Avenue PO Box 1130 ~ o.hkosh WI ~ 54903-1130 OJHKOfH ON 'THE WATER City of Oshkosh Approved: 5/3/05 Issued: 5/5/05 Midwest General Contractors Inc. 100 N. Westhaven Drive Oshkosh, Wisconsin 54904-7426 CERTIFICATE OF OCCUPANCY An Occupancy Permit is hereby granted for the multi-family residence located at 456 Wyldewood Drive, Oshkosh, Wisconsin 54904 as described in Building Permit Application number(s) 106711. This building is to be used only as a 6 unit condo and is located in the R-3PD, Multiple Dwelling District with a Planned Development Overlay. LIMITATIONS: Maximum persons and/or living units: Six living units CONDITIONS: 1) Final grading must be done in accordance with the approved subdivision drainage plan. This plan is on file in the public works office, 3rd floor of City Hall. 2) Erosion control measures must be maintained until the lawn is established. Note: Final grade must be a minimum of 6" below all siding. NOTE: 1) Copies of inspection results are available upon request in room 205, City Hall. 2) Future permits may be required for additional work to your property. 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 certificate to be valid. Dt~{tuJ ~ Building Systems Inspector ~ Building Permit Work Card fob Address 456 WYLDEWOOD DR Permit Number 0106711 Create Date 2/16/04 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building o Sign o Canopy o Fence o Raze -~ Plan K1-128-1203 Zoning Class of Const: VBibc Size irreg Value $474,000.00 ~ Sq. Finished/Living Garage Unfinished/Basement 0 0 Sq. Ft. 0 Sq.Ft. , Ft. - Rooms 0 Bedrooms 0 Baths 0 o Projection I - - Stories 1 Height 0 Ft. Canopies 0 Signs 0 - Foundation . Poured Concrete o Floating Slab o Pier o Other o Concrete Block o Post o Treated Wood Occupany Permit Required Flood Plain No Height Permit Not Required - Park Dedication Required # Dwelling Units 6 # Structures 1 Use/Nature 6 Unit Condo / 4 Units @1442sf, 2 Units @ 1321 sf, all with 440 sf garage. of Work HV AC Contr Plumbing Contr Electric Contr Inspections: Date 5/3/05 Type Final,.".,~~;lt ~";';':-" Inspector Nicole Krahn "~~'y~.ii:,L , romPI;ao~ ~ffimaom -;~ Date/Time requested: 5/3/05 Access: I' 08:53 AM Notice Type: Phone Number: ] Ready Date/Time: 5/3/05 08:53 AM Requested By: o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid . I Building Permit Work Card Sob Address 456 WYLDEWOOD DR Permit Number 0106711 CrElate Date 2/16/04 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building o Sign o Canopy o Fence o Raze I Plan K1-128-1203 Zoning Class of Const: VBibc Size irreg Value $474,000.00 . Sq. Finished/Living 0 Sq.Ft. Garage 0 Sq.Ft. Unfinished/Basement 0 -Ft. - Rooms 0 Bedrooms 0 Baths 0 o Projection I Stories 1 Height 0 Ft. Canopies 0 Signs 0 - - Foundation . Poured Concrete o Floating Slab o Pier o Other o Concrete Block o Post o Treated Wood Occupany Permit Required Flood Plain No Height Permit Not Required - Park Dedication Required # Dwelling Units 6 # Structures 1 Use/Nature o Unit Condo / 4 Units @1442 sf, 2 Units @ 1321 sf, all with 440 sf garage. of Work HV AC Contr Plumbing Contr Electric Contr Inspections: Date 10/26/04 [REQUEST LINE Type Insulation Inspector Nicole Krahn approved Date/Time requested: 10/25/04 05:02 PM Notice Type: Phone Number: JAY 420-5878 Access: PPEN 7-5, INSPECTORS HAVE KEYS Ready Date/Time: 10/25/04 05:02 PM Requested By: MIDWEST GENERAL CONTRACTORS It o Reinspect Fee 0 Fee Waived :J o Reinspect Fee Paid Date 4/14/05 Type Final Inspector Nicole Krahn not approved !REQUEST LINE / JAY WOULD LIKE TO BE PRESENT AND WOULD LIKE INSPECTION ON THURSDAY Need compliance statements and rear exits off the decks are not installed. ' ,/20/05 Jay called to state that the steps were installed off the rear decks. I I Date/Time requested: 4/12/05 Access: IOPEN 7-5 Ready Date/Time: 4/14/05 04:38 PM Notice Type: Phone Number: JAY 420-5878 :J Requested By: MIDWEST GENERAL CONTRACTORS It o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Building Permit Work Card job Address 456 WYLDEWOOD DR Permit Number 0106711 Create Date 2/16/04 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building 0 Sign o Canopy o Fence o Raze Plan K1-128-1203 Zoning Class of Const: VBibc Size irreg Value $474,000.00 Unfinished/Basement 0 Rooms 0 Sq. Ft. Bedrooms Finished/Living 0 Sq. Ft. Garage 0 Sq.Ft. - 0 Baths 0 o Projection I Height 0 Ft. Canopies 0 Signs 0 - - o Floating Slab o Pier o Other o Post o Treated Wood Stories Foundation . Poured Concrete o Concrete Block Occupany Permit Required Flood Plain No Height Permit Not Required Park Dedication Required # Dwelfing Units 6 # Structures Use/Nature 16 Unit Condo / 4 Units @1442 sf, 2 Units @1321 sf, all with 440 sf garage. of Work HV AC Contr Plumbing Contr Electric Contr Inspections: Date 9/24/04 Type Inspector Nicole Krahn FAXED REQUEST / INSPECTION FOR FLASHING ON PORCHS & GARAGES no time DatefTime requested: 9/23/04 Access: 01 :27 PM Notice Type: Phone Number: 231-1667 JANELL ] Ready DatefTime: 9/23/04 01 :27 PM Requested By: JOHN SKOTZKE CONCRETE CONST o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Date 10/18/04 rEQUEST LINE DatelTime requested: Access: IOPEN 7-5 Ready DatefTime: 10/15/04 09:59 AM Requested By: MIDWEST GENERAL CONTRACTORS It o Reinspect Fee 0 Fee Waived Type Rough In Inspector Nicole Krahn no time 10/15/04 0~:59 AM Notice Type: Phone Number: JAY 420-5878 ] o Reinspect Fee Paid Building Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 0106711 Create Date 2/16/04 Owner WYLDEWOODCONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building o Sign o Canopy o Fence o Raze I Plan K1-128-1203 Zoning Class of Const: VBibc Size irreg Value $474,000.00 - . Unfinished/Basement 0 Sq. Finished/Living 0 Sq.Ft. Garage 0 Sq.Ft. Ft. o Projection I Rooms 0 Bedrooms 0 Baths 0 - Stories 1 Height 0 Ft. Canopies 0 Signs 0 - - Foundation . Poured Concrete o Floating Slab o Pier o Other o Concrete Block o Post o Treated Wood pccupany Permit Required Flood Plain No Height Permit Not Required - Park Dedication Required # Dwelling Units 6 . # Structures 1 Use/Nature ~ Unit Condo / 4 Units @1442 sf, 2TJnits @ 1321 sf, all with 440 sf garage. of Work HV AC Contr Plumbing Contr Electric Contr Inspections: Date 7/26/04 Type Re Foundation Inspector Nicole Krahn approved w/cond. REQUEST LINE The foundation was backfilled: I-could not verify the repair. Jay w/ Midwest stated that a wall was poured under the umps. DatefTime requested: 7/22/04 Access: 01 :32 PM Notice Type: Phone Number: JAY 420-5878 ] Ready DatefTime: 7/22/04 01:32 PM Requested By: MIDWEST GENERAL CONTRACTORS It o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Date 8/2/04 Type Drain Tile Inspector Nicole Krahn approved [FAXED REQUEST DatefTime requested: 8/2/04 07:49 AM Notice Type: Phone Number: 231-1667 Access: !NOTIFY JANELL 231-1144 378-4380 Ready DatefTime: 8/2/04 07:49 AM Requested By: JOHN SKOTZKE CONCRETE CONST o Reinspect Fee 0 Fee Waived ] o Reinspect Fee Paid Building Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 0106711 Create Date 2/16/04 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building Zoning Unfinished/Basement Rooms 0 o Sign o Canopy o Fence o Raze Class of Const: VBibc Size irreg 0 Sq. Finished/Living 0 Sq. Ft. Ft. Bedrooms 0 Baths 0 - Plan K1-128-1203 Value $474,000.00 Garage ~ Sq. Ft. o Projection I Stories Height o Ft. Canopies o Signs o Foundation . Poured Concrete o Concrete Block o Floating Slab o Post o Pier o Treated Wood o Other pccupany Permit Required Park Dedication Required Flood Plain No Height Permit Not Required # Dwelling Units 6 # Structures Use/Nature '6 Unit Condo / 4 Units @1442 sf, 2 Units @ 1321 sf, all with 440 sf garage. of Work HV AC Contr Plumbing Contr Electric Contr Inspections: Date 7/12/04 Type Foundation Backfill Inspector Nicole Krahn cancelled Faxed request (received 3: 17 PM states ready 11 :00-12:00) DatefTime requested: 7/9/04 Access: 03:17 PM Notice Type: Phone Number: 231-1667 ] Ready DatefTime: 7/9/04 03:17 PM Requested By: JOHN SKOTZKE CONCRETE CONST-Mi o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Type Foundation Backfill Inspector Nicole Krahn not approved Date 7/14/04 Request Line 6'-12' FOUNDATION JUMPS LOCATED ALONG BEARING WALLS DUE TO THE SEWER. I CALLED JAY TO INFORM HIM THAT WE WOULD NEED CALCS OR A REPAIR. Date/Time requested: 7/14/04 Access: 07:09 AM Notice Type: Phone Number: 420-5878 ] Ready DatefTime: 7/14/04 07:09 AM Requested By: MIDWEST GENERAL CONTRACTORS It o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid .. Building Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 0106711 Create Date 2/16/04 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor MIDWEST GENERAL CONTRACTORS INC Category 130 - New Multi-Family Type . Building Zoning Unfinished/Basement Rooms 0 D Sign o Canopy o Fence o Raze Class of Const: VBibc Size irreg 0 Sq. Finished/Living 0 Sq.Ft. Ft. Bedrooms 0 Baths 0 Plan K1-128-1203 Value $474,000.00 Garage ~ Sq. Ft. D Projection I Stories Foundation . Poured Concrete o Concrete Block Height o Ft. Canopies o Signs o o Floating Slab o Post o Pier o Treated Wood o Other Occupany Permit Required Flood Plain No Height Permit Not Required Park Dedication Required # Dwelling Units 6 # Structures Use/Nature ~Dnit Co-riC!o / 4 Units @1442 sf, 2 Units @ 1321 sf, all with 440 sf garage. of Work : HV AC Contr Plumbing Contr Electric Contr Inspections: Date 6/23/04 Type Footings IFAXED REQUEST I READY BETWEEN 3 & 4 PM DatelTime requested: 6/23/04 04:21 AM Access: Inspector Nicole Krahn no time Notice Type: Phone Number: MIKE OR TOM 231-1667 ] Ready DatelTime: 6/23/04 03:00 PM Requested By: JOHN SKOTZKE CONCRETE CONST o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Date 7/8/04 Type Foundation Backfill Inspector Nicole Krahn cancelled ,AXED REQUEST I READY BETWEEN 2 & 3 DatelTime requested: 7/8/04 07:44 AM Access: Notice Type: Phone Number: MIKE OR TOM 231-1667 ] Ready DatelTime: 7/8/04 02:00 PM Requested By: JOHN SKOTZKE CONCRETE CONST o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid HVAC Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 110797 Create Date 09/28/2004 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor BREWER HEATING Category 512 - Ind. & Comm-Both Plan K1-128-1203 , Fuel ~ Gas I UOil I U Electric I U Solar I U Solid I Value $27,000.00 System ~ New I o Replace I o Other I ~ Forced Air I U Radiant I U Steam I ~ AfC I U Vent I U Electric I U Hot Water I U Suppl. I U Con. Burner I Chimney Type K) Chimney A () Chimney B . Direct Vent () Not Applicable I Heat Loss . As Approved o Existing o Not Applicable I Value 0 BTU Rate . As Per Plan o Variable o Other I Value Use/Nature HVAC system for 6 unit as per State Transaction ID No. 976043 of Work Inspections: Date 5/3/05 Type Final Inspector Nicole Krahn approved DatelTime requested: Notice Type: Phone Number: Access: Ready DatelTime: Requested By: o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid -------------------------------------------------------------------'--~---------------------- Electric Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 110656 Create Date 09/22/2004 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor CUMINGS ELECTRIC !NC Category 631 - Residential-New Multi-Family Wiring ..~fIJ I Type . Underground I Service KJNew o ChangeO Temp ON/A o Overhead ON/A Volts 110/220 Circuits 0 Fixtures 0 , Amps 400 Switches 0 Receptacles 0 Fee $234.00 0 Value $18,000.00 Appliances ange, water heater, disposal, dryer, dishwasher, fan, furnace, a-c. Use/Nature ~ire new 6 unit of Work Inspections: Date 04/08/2005 Type Final Inspector Kevin Benner approved wIeand. Request Line The post lights are not installed. No access to .unit "E". DatefTime requested: 04/07/2005 07:14 AM Access: Notice Type: Phone Number: Ready DatefTime: 04/07/200507:14 AM Requested by: CUMINGS ELECTRIC INC-Jan o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Electric Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 110656 Create Date 09/22/2004 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor CUMINGS ELECTRIC INC Category 631 - Residential-New Multi-Family Wiring ~~w " I Type Service o ChangeO Temp ON/A o Overhead . Underground ON/A I Volts 110/220 . Circuits 0 Fixtures 0 . Amps 400 Switches 0 Receptacles 0 Fee $234.00 0 Value $18,000.00 Appliances ange, water heater, disposal, dryer, dishwasher, fan, furnace, a-c. Use/Nature Hire new 6 unit of Work Inspections: Date Type Rough In Inspector Kevin Benner no time REQUEST LINE / UNITS A THRU F DatelTime requested: 10/15/2004 08:11 AM Access: Notice Type: Phone Number: NOT GIVEN Ready DatelTime: 10/15/2004: PM o Reinspect Fee 0 Fee Wavied Requested by: o Reinspect Fee Paid CUMINGS ELECTRIC INC Date Type Note Inspector Jon Fischer Request Line DatelTime requested: 11/03/2004 01:58 PM Access: Notice Type: Phone Number: Ready DatelTime: 11/03/2004 01 :58 PM Requested by: CUMINGS ELECTRIC INC-Jan o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Electric Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 110656 Create Date 09/22/2004 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor CUMINGS ELECTRIC INC Category 631 - Residential-New Multi-Family Wiring ~ew .. Service o ChangeO Temp ON/A I Type o Overhead . Underground ON/A I Volts 110/220 . Circuits 0 Fixtures 0 Amps 400 Switches 0 Receptacles 0 Fee $234.00 0 Value $18,000.00 Appliances range, water heater, disposal, dryer, dishwasher, fan, furnace, a-c. Use/Nature wire new 6 unit of Work Inspections: Date Type Service Inspector Kevin Benner DatefTime requested: 11/04/2004 07:33 AM Access: Notice Type: Phone Number: Ready DatefTime: 11/04/2004 07:33 AM Requested by: CUMINGS ELECTRIC INC (Richard) o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Date 11/05/2004 Type Service Inspector Jon Fischer approved Request Line -- public service needs to be contacted. 11/5/04 called in 11/8/04 mailed in Date/Time requested: 11/05/2004 09:11 AM Access: Notice Type: Phone Number: Ready DatefTime: 11/05/2004 09:11 AM Requested by: CUMINGS ELECTRIC INC o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Job Address 456 WYLDEWOOD DR Owner WYLDEWOOD CONDOMINIUMS LLC Category Bathtub Whirlpool Lavatory Toilet Misc. Fixtures Use/Nature of Work 440 - Industrial-Interior ------;- ~ Shower o Floor Drain ~ ,Lndry Tray ---.1.!! Disposal ~ Dishwasher ~ SumpPump ~ Classrm Sink ~ Breakrm Sink ~ Ejector/Grind o Res. Sink Bar Sink Water Heater Site Drain Roof Drain Plumbing Permit Work Card Permit Number 109011 Contractor WATTERS PLUMBING Plan C6-96-0404-P Create Date 06/29/2004 Value 12 Water Softner 0 Wait. St. 0 Shamp Sink 0 6 Local Waste 0 Ice Chest 0 Flr/Wst Sink 0 - 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 6 Bidet 0 Sculry Sink 0 Wash Ftn 0 - 6 Beer Tap 0 Hand Sink 0 Urinal 0 - 6 Lab Sink 0 Plaster Sink 0 Standp Rec 0 - 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 6 - 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0 Coffee Maker Int Grease Trap Ext Grease Trap RPZ Valve Eye Wash Statn Wtr Sewer Mtrs Deduct Meters Wtr Usage Mtrs NEW 6UNIT CONDO INTERIOR ONLY ~ $32,010.00 o o o o o o o o Size Sanitary Sewer Storm Sewer Water Service Date 3/31/05 FAXED REQUEST Type Final Material Type # Conn.Type 0 0 0 0 0 0 0 0 0 0 DatefTime requested: 3/30/05 01 :15 PM o o o o o Inspector WJ (Chip) Callies approved Notice Type: Telephone Number: JAMIE 733-8125 Access: ~A Y 420-5878 Ready DatefTime: 3/30/05 02:00 PM Requested By: WATTERS PLUMBING o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid ] --------------------------------------------------------------------------------------------------------- . Plumbing Permit Work Card Job Address 456 WYLDEWOOD DR Permit Number 109011 Create Date 06/29/2004 Owner WYLDEWOOD CONDOMINIUMS LLC Contractor WATTERS PLUMBING Category 440 - Industrial-Interior Plan C6-96-0404-P Value $32,010.00 Bathtub 6 Shower 12 Water Softner 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0 - Whirlpool 0 Floor Drain 6 Local Waste 0 Ice Chest 0 FlrfWst Sink 0 Int Grease Trap 0 - Lavatory 24 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Toilet 18 Disposal 6 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0 - Res. Sink 6 Dishwasher 6 Beer Tap 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0 - Bar Sink 0 Sump Pump 6 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0 - Water Heater 6 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 6 Deduct Meters 0 - Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0 Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0 Misc. 0 Fixtures Use/Nature of Work NEW 6UNIT CONDO INTERIOR ONLY ~ Size Material Type # Conn.Type 0 0 0 0 0 0 0 0 0 0 Sanitary Sewer . ; Storm Sewer Water Service Type Rough In o o o o o Inspector WJ (Chip) Callies no time Date axed request DatefTime requested: 10/5/04 07:18 AM Notice Type: Telephone Number: 733-8125 Access: ] Ready DatefTime: 10/5/04 08:00 AM Requested By: WATTERS PLUMBING o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid Job Address 456 WYLDEWOOD DR Owner WYLDEWOOD CONDOMINIUMS LLC Category 440 - Industfial-Interior Bathtub 6 Shower Whirlpool 0 Floor Dtain Lavatory 24 . Lndry Tray Toilet 18 Disposal Res. Sink 6 Dishwasher Bar Sink 0 Sump Pump Water Heater 6 Classrm Sink Site Drain 0 Breakrm Sink Roof Drain 0 Ejector/Grind Misc. 0 Fixtures Plumbing Permit Work Card Permit Number 109011 Contractor WATTERS PLUMBING Plan C6-96-0404-P o Wait. St. 0 Shamp Sink o Ice Chest 0 Flr/Wst Sink o Exam Sink 0 Catch Basin o Sculry Sink 0 Wash Ftn o Hand Sink 0 Urinal o Plaster Sink 0 Standp Rec o Surgeons Sink 0 Ice Maker o F Prep Sink 0 Gar Drain o Serv Sink 0 Soda Disp 12 Water Softner 6 Local Waste o 6 6 6 o o o Clothes Wshr Bidet Beer Tap Lab Sink Sterilizer Dip Well Drink Ftn Create Date 06/29/2004 $32,010.00 o o o o o o o o Value o Coffee Maker Oint Grease Trap o Ext Grease Trap o RPZ Valve o Eye Wash Statn o Wtr Sewer Mtrs 6 Deduct Meters o Wtr Usage Mtrs o NEW 6UNIT CONDO INTERIOR ONLY Use/Nature of Work ~ Material Size Type # Conn.Type 0 0 0 0 0 0 0 0 0 0 Sanitary Sewer Storm Sewer Water Service o o o o o Inspector WJ (Chip) Callies no time Date Type Underground FAXED REQUEST DatelTime requested: 7/29/04 12:16 PM Notice Type: Telephone Number: JAMIE 733-8125 Access: ] Ready DatefTime: 7/29/04 12:16 PM Requested By: WATTERS PLUMBING o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid --~----------------------------------------------------------------------------------------.------------- '" . . Buildings, 'HV AC, Compliance Statement This form i:s required to be SUbmitted' by the 8upervisi~ professional (architect. 1tl"l9in~, HVAC designer or electrical designer) observing construction of projeds within buildings with total areas 60.000 cubIc; fee~ or greater and bleachers (Comm SO.1 O/C~m 61.50). Failura to submit this form may result in ~naltje:; as specified In Comm 50..261Comm 61.23 and/or IOCDI ordinances. General Jnstructions: PriOr to tr'le initial oc::cupancy of new buildings. or additions and the final OCcupancy of altered existing builcfing$. submit this completed snd signed 10m to: J · The municipal building inspection office a~ .,... · Safety and Buildings, 'T054'N Ranch Road Hayward. Wi. 54843 Person::/.I il'lfo~n you proViClc may t)e u:u:ad for :sec:ondwy pUtpOllQS (Privla<.)' Law, s. 15.04 (1 )(m)l 1. PROJECT IN;"?ORMAnON: Please fill in the following with information from your plan approval letter. TranS3ction JO Number 7'1r:~4';' Site Number <:, '?S7& I r [' Site Ioc:.l!tion (number & street) J,~Q "'-J ld..wed - *' (p ~ lkl<:axt- IIi !elr-- [B"""City D Village 0 Town of at'~4J'H County of L.J. ,,/tJ~J~~i'A 2. PURPOSE OF THIS STATEMENT: (Check Box A. B, C. or 0 to indicato ~urpO$e OlInd completo ~ny other applicable l>Oxes and information. Attach additionsl pages jf necessary.) Check those which apply: 0 Building Object ID # B'HVAC OOject 10 11 f 1-5 ~/ i. Cl Lighting Objed'IO # '! C Parrial Completion o..cription of PMion COmpleted A} ~tatem.l1t of Substantial Compliance To the best of my knowledge. belief, and ~ed on onaite obset\<ation. eonStn.lctio" of tne following building and/or HVAC items applic.blv to tI'li.s project have belen completed in $utl:il~nti31 compliance with tne approl.'9d plans and sPOcl1'lCllttO"f; . o eUIlDING/UGHnNG ITEMS '. SlrV~r'lIl S>'S1'e1l'J incl~o;ng S\,lbm;nal and cr~c:ion Of ..II t)"'ilttil'lg components lll'Us.SCs. j)recr.sl, melal Ouijdln;. etc.) 2. Fire croteaiOft sysr:em:s ISCl~nklers. a.larms. smOlle c2et~C:OrsJ aeslgr;el::. il'l$tIlllfld. aM teste., (indudlrl' fcrward flow on !:lad< lIow l::evice3) Oy oIIppropn.lltely rwgil5l8t'8d pro1sa15lonals 3. S"'.,ft ,nCl s~irway enQosure 4. Exits inClUding e.ll'l.;:lnd djrec:liQTIalligh~ 5. FI~Sl.llllive CXlnstruc1:lCln. endcsure of tlazards. lire ....<llIs. laCleIeC: coors, Clan of con:;~l'l. fire :;lOppad ponolt:lliOI'l4: 6. S3nillliOtl :!I)'srem (toile", sinlts. lftlrlking fadlith.5) 7. ellrrier-f~ inClII.,ing Comm 18 !!leVlilOrs and lift:s 8. Enel'9Y enweIOptr.~uirel'l1enls 9. All Conditions Of bI.Iilding Illan 4PPrQv". ~nd appliQt)le ...ati~lIeo:::; Tho following l1ems are nOl in c:ompli;Jlnc:e and must tJo addressed: , / '0. E;.;lCrlQf li~tltil1" & conlrOl rOQuircmtn1.5 11. Il'llCrior lj~"ng 150 cOtttrOl rec:ui(erl'\etl~ ,~. All condit:ons ot lig!1ting plan <Ipproval .lIf1' lJppliC:ll~le vlrianl;e5 o HVAC IT&MS 1. MVAC SYSteM includinlO final reSl 2. All CQtldlllClrloli of I'tV AC pIa" :loprO"31 :!f':C: lIppliCil~Je varilnOIl$ B) 0 Statement of Non~mpfiance Due to the following listed vlol~ons, this project is not ready for o<x:upancy: C) 0 Supervising Professional Witncfrawn From Project (Use A Or B B/k)w>o lQ indicate project statllS as of this date.) 0) 0 Project Abandoned 3. SUPERV'SING PROFESSIONAL SIGNATURE FOR: CJ 6uilding K'HVAC 0 Lighting --.1:21\/(\ 6t'?".I;:'te.. Name (please print or typG) ~ Customer 10 # ~ 8'.2~ II P!'lO"~ numl)cr Z.,;,... 74., ..:J't>,! Sigl'llllture SBO.9no (l't.O I 12002) 23 2'd r ji:d~ L -, __ 02S9-8vL-026 ~u~...eaH ..Iama..lH dl0:tO so 12 ..Idl:l RIO; 21 05 02:3210 DON HRRNEN r 920-497-5007 P. 1 Buildings, HV AC Compliance Statement 5BO-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 50.10/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. General InstrLJ[!tions: 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 Personal infonnation you provide may be used for secondary purposes [Privacy Law, s, 15.04 (1 )(m)J. 1. PROJECT INFORMATION: Please tiU in the following with information from your plan approval Jetter. Transaction ID Number 937355 Site Number 667578 Site location (number & street) 456 WYLDEWOOD o City 0 Village D Town Of OSHKOSH Jrb County of W1NNEBAGO 2. PURPOSE OF THIS STATE:MENT: (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 10# 928334 0 HVAC Object 10# o Lighting Object ro# o 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 applicable to this project have been completed in substantial compliance with the approved plans and specifications. o BUILDING/LIGHTING 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, tire 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 The following items are not in compliance and must be addressed: 10. Exterior lighting & control requirements 11_ Interior lighting & control requirements 12. All conditions of lighting plan approval and applicable variances o HVAC ITEMS 1_ HVAC system including final test 2. All conditions of HVAC plan approval and applicable variances 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: o Building 0 HVAC 0 Lighting Phone #. Name (please print or type) Customer 10# 649536 Signature ' 920-497-5007 SBD-9720 (R.Ot/2003) .-.-----~-: 4/20/2005