Loading...
HomeMy WebLinkAboutBuilding E8-50-486B SalelY & Buddin", Division 201 E. Wasl1lnglon Ave. P.O. Bex 7969 Madison, WI 53707 PLANS APPROVAL APPLICATION Department of INDUSTRY, LABOR AND HUMAN RELATIONS E- PLAN NO~->l- 56-4'<sc"B INSTRUCTIONS: F ill in all applicable dota. Submittal of Plan Approval Application form is required with each plan submittal. Examination and, inspection fees, as indicated on ~ack of form, are required to be submitted with a minimum 01 lour sets 01 plans. Data required on plans is described in code section Ind. 50.12. Codes can be purchased from the Department of Administration, Document Sales, 202 S. Thornton Ave., Madison, 53702 "y. Name of Owner Building Occupancy or Use Designer or Design firm of ~BLDG oHVAC James Hepola Office Buildina Rpinke H T,"'''''''' Tn,... Company Tenant Name, if any Street & No. Northwestern Mutual 805 N. Main Street Street & No. Building location, Street & No. '. City State & Zip 251 N. Westfield 303 High Ave 'Oshkosh WI 54901 City State & Zip City kJ County Phone Oshkosh WI 54901 Village. 0 Winnebago 414-231-6950 Town.. 0 PreJ:OUS Owner. if any Return Plans to DOwner I&lDesigner o Orher THIS APPLICATION IS FOR: Type of Construction (lnd 51.03) o Sp,inkler System Provided FOR OFFICE USE ONLY X Buiiding PI"n Approval 0 Fire Resistive-Type A # 1 o Fire Alarm Provided :J H\iAC Plan Approval o Fire Resistive-Type B #2 o Other Detection System Provided Amt. Rec'd. ::J Orher o Metal Frame Protected #3 o Emergency Power Provided PLANS FOR: o Heavy Timber # 4 Mechanical Information: 0 New Building o Exterior Masonry #5A Type of He~ting Rept. No, Xi Addition o Exterior Masonry #58 - Alterction o Metal Frame Unprotected #6 DETERMINAnON OF FEES ....; - Revision to previously approved plans o Wood Frame Protected #7 -' ----- Cj Structural ~ Wood Frame Unprotected #8 Area Height Volume - Fooiing& Foundation SOIL BEARINGS CAPACITY '- I [j Other Method used oVerified X = cu. ft. I Check one: !iaPresumptive X I Value used: = cu. ft. :i.nnn PSF Total Volume or Total Area of Alteration - I Total Vol. /lOGO (Buildingl Minimum Fee S60.00' COMPONENTS INCLUDED WITH THIS SUBMITTAL i NOTE: Must be submitted by building designer X 1.00 = $ 60.00 Designer Name I ~eg. No. Total Vol./l000 (HVAC) M(;;T,:num Fee 560.00 METAL X .75 - S BUILDING Supplier Alt. Area Minimum Fee S 60.00 X .02 = S Designer Name I Reg. No. r OStructural OExhaust Olllumination TRUSSES oFtg & Found ORevision $ Suppl ier o PRIORITY PLAN REVIEW. Designer Name I Reg. No. I FEE IS EQUAL TO THE TOTAL PLAN --- PRECAST EXAMINATION FEES ABOVE. S CONCRETE Supplier o Permit to start S 60.00 $ Designer Name I R~g. No. PUBLIC RECORDS: Inspection Fee lAMINATED WOOD Supplier This plan, and re/~ted documents, may be 75.00 subject to public inspection and copying, $ Designer Name I Reg. No. See Ind. 69.09(8) for additional informa- Total OTHER I tion regarding public records. . (SPECIFY) Supplier I $135 . nn DESIGN AND SUPERVISION (Ind. 50.07.50.10) Wisconsin Registered Professional required for buildings, containing more than 50,000 cu,ft., total volume. This project has been prepared under my supervision. Individual components, submitted herein, may have been designed and sealed by others. I have reviewed those component documents for conformance with the general design concept. I have relied on the seal of the component designers for compliance with codes as they apply to their design. If this su bmittal includes building, or building components, the designer and supervising professional below must be that of the building, If submittal is for HV AC, only. blocks below may be completed by HVAC designer and supervisq Name of IX SLDG 0 HV AC Designer Type or Print Reg. No. Si ~u~of ~ BL Date Ronald D. Hansche A2457 - 3/25/86 Reg. No. A2457 Date 805 N. Main Street Oshkosh, WI 54901