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Home My WebLink AboutCertificate of Occupancy CITY HALL Inspection Services Div 215 Church Avenue ~POBOX1130 ~ Oshkosh WI . .~ 54903.1130 OJHKOfH ON THE WATER City of Oshkosh Approved: Issued: 12/05/2006 12/07/2006 Landmark L TO Partnership III PO Box 2366 Oshkosh WI 54903-2366 CERTIFICATE OF OCCUPANCY An Occupancy Permit is hereby issued for the U Bake located at 374 S Koeller St. as described in Building Permit #122564. This building is to be used as Mercantile/Retail and is located in the C-2 General Commercial District. LIMITATIONS: Maximum number of persons: 25 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. cc: R J Albright Inc Building Permit Work Card Job Address 356-3S6 S KOELLER ST Permit Number 0122564 Create Date 11/14/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor R J ALBRIGHT INC. Category 232 - Alteration Stores & Customer Service Type . Building o Sign o Canopy o Fence o Raze I Plan W1-109-1106 Zoning Class of Const: Size No Change Value $21,000.00 - Unfinished/Basement Sq. Finished/Living Sq.Ft. Garage Sq. Ft. Ft. - Rooms Bedrooms Baths o Projection I - - Stories Height Ft. Canopies Signs - - Foundation o Poured Concrete o Floating Slab o Pier . Other o Concrete Block o Post o Treated Wood Occupany Permit Required Flood Plain Height Permit - Park Dedication # Dwelling Units 0 # Structures 0 Use/Nature ~74 S Koeller/Interior alterations for new tenant.* Late Permit, Rough Inspection Requested on 11/14/06 of Work prior to securing the required permit. HV AC Contr Plumbing Contr - ----~-~--_._-- Electric Contr Inspections: Date 11/15/2006 : AM Type Rough In Inspector Allyn Dannhoff approved Request line / Ready for a rough inspection. 11/15/2006 No concerns noted - NOTE: work commenced prior to permit issuance. Date/Time requested: 11/14/2006 07:55 AM Access: Notice Type: Phone Number: 231-8635 -~ Ready Date/Time: 11/14/200607:55 AM Requested By: R J ALBRIGHT INC. - Debbie o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid : AM Typ~:'Firulr". Inspector Allyn Dannhoff approved Date 12/5/2006 I J DatefTime requested: Access: Notice Type: Phone Number: c __------...J Ready Date/Time: __ Requested By: o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid Page 1 of 1 Electric Permit Work Card ,'] Job A,}dress 356-386 S KO~LLER ST Permit Number 122528 Create Date 11/13/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor SOLAR ELECTRIC SERVICES INC Category 643 - Commercial-Addition/Remodels Service b New 0 ChangeO Temp . N/A I Type 0 Overhead o Underground . N/A Volts Circuits Luminaires Fee $128.00 o Receptacles Value $5,000.00 Amps Switches Appliances Use/Nature of Work 374/ U Bake - Remodel an existing tenant space for a Bread Store. Inspections: Type Re Final Inspector Kevin Benner ____ approvedw/cond. Date 11/30/2006 Curtis called 11/30/610:54 AM and stated that the following noted violations are corrected.: The sign circuit wiring is disconnected from its source at the time clock, K.O. closure is installed for the freezer compressor rack, freezer heat tape conversion to a flexible cord a box is now installed. No work was done above the suspended ceiling per Curtis. Date/Time requested: 11/29/2006 00:00 AM Access: Notice Type: Phone Number: 410-5173 Curtis Ready Date/Time: 11/30/2006 00:00 AM Requested by: Building Inspector o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Electric Permit Work Card Job ,4;,,)dress 356-386 S KO!=LLER ST Permit Number 122528 Create Date 11/13/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor SOLAR ELECTRIC SERVICES INC Category 643 - Commercial-Addition/Remodels Service b New o Change 0 Temp . N/A I Type 0 Overhead o Underground . N/A I Volts Circuits Luminaires Amps Switches Receptacles Fee $128.00 0 Value $5,000.00 Appliances Use/Nature 1t374/ U Bake - Remodel an existing tenant space for a Bread Store. of Work Inspections: Date 11/14/2006 Type Rough In Inspector Kevin Benner approvedw/cond. Request Line / Ready for a rough inspection Need to relocate two ENT's in the wall between the office and the restroom so that the raceways fit in the wall cavity. Called Curtis and noted this on the sticker let on the permit placard. Date/Time requested: 11/14/2006 09:13 AM Access: Store #374 should be open Ready Date/Time: 11/14/2006 09: 13 AM Requested by: SOLAR ELECTRIC SERVICES INC - Carte o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid Notice Type: Phone Number: (920) 410-5173 Date 11/29/2006 Type Final Inspector Kevin Benner not approved Request line No access because the flooring was being installed Date/Time requested: 11/28/2006 10:03 AM Access: Notice Type: Phone Number: Curtis - 410-5173 Ready Date/Time: 11/28/200610:03 AM Requested by: SOLAR ELECTRIC SERVICES INC o Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid HVAC Permit Work Card Job Address 356-386 S KOELLER ST Permit Number 122659 Create Date 11/22/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor GARTMAN MECHANICAL SERVICES Category 512 - Ind. & Comm-Both Plan Fuel ~ Gas I UOil I U Electric I U Solar I U Solid I Value $1,865.00 System o New I o Replace I ~ Other I l!J Forced Air I U Radiant I U Steam I U A/C I l!J Vent I U Electric I U Hot Water I U Suppl. I U Con. Burner I Chimney Type o Chimney A o Chimney B o Direct Vent . Not Applicable I Heat Loss o As Approved . Existing o Not Applicable I Value BTU Rate . As Per Plan o Variable o Other I Value Use/Nature 374 S Koeller/ U-Bake Store - HV AC alterations as per plans. of Work ..' Inspections: Date 12/5/2006 Type Firi'm-.""'''';<- Inspector Allyn Dannhoff approved DatefTime requested: Notice Type: Phone Number: Access: Ready DatefTime: Requested By: o Reinspect Fee 0 Fee Waived o Reinspect Fee Paid . . . Plumbing Permit Work Card "" I Job Address 356-386 S KOELLER ST Permit Number 122414 Create Date 11/06/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor DR HANSEN PLBG. Category 440 - Industrial-Interior Plan Value $8,000.00 Bathtub - Shower Water Softner Wait. St. Shamp Sink - Coffee Maker - - - - Whirlpool Floor Drain 3 Local Waste Ice Chest FlrlWst Sink - Int Grease Trap - - - - - Lavatory 2 Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap - - - - - Toilet 1 Disposal Bidet Sculry Sink 1 Wash Ftn RPZ Valve - - - - - Res. Sink Dishwasher Beer Tap Hand Sink 1 Urinal Eye Wash Statn - - - - - - Bar Sink - Sump Pump ------ Lab Sink Plaster Sink - Standp Rec ~--,_.._- Wtr Sewer Mtrs - - Water Heater - Classrm Sink - Sterilizer Surgeons Sink - Ice Maker - Deduct Meters - - Site Drain Breakrm Sink Dip Well F Prep Sink 1 Gar Drain Wtr Usage Mtrs - - - - - Roof Drain Ejector/Grind Drink Ftn Serv Sink 1 Soda Disp - - - - - Misc. - Fixtures Use/Nature Remodle tennant space for bakery supply operations***Debit Account of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service f " Inspector Paul Wolf approved Date 11/30/2006 Type Re Final I I DatefTime requested: 12/1/200607:22 AM Notice Type: Telephone Number: Access: Ready DatefTime: 12/1/2006 Q.?-=-~2~~_ Requested By: D.R. HANSEN PLBG. o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid . Plumbing Permit Work Card . Job Address 356-386 S KOELLER ST Permit Number 122414 Create Date 11/06/2006 I Owner LANDMARK LIMITED PARTNERSHIP III Contractor D.R. HANSEN PLBG. Category 440 - Industrial-Interior Plan Value $8,000.00 Bathtub Shower Water Softner Wait. St. Shamp Sink - Coffee Maker - - - - - Whirlpool - Floor Drain 3 Local Waste Ice Chest - FlrlWst Sink - Int Grease Trap - - - Lavatory 2 Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap - - - - - Toilet 1 Disposal Bidet Sculry Sink 1 Wash Ftn RPZ Valve - - - - - Res. Sink Dishwasher Beer Tap Hand Sink 1 Urinal Eye Wash Statn - - - - - - Bar Sink - Sump Pump - Lab Sink Plaster Sink - Standp Rec - Wtr Sewer Mtrs - - Water Heater - Classrm Sink - Sterilizer Surgeons Sink - Ice Maker - Deduct Meters - - Site Drain Breakrm Sink Dip Well F Prep Sink 1 Gar Drain - Wtr Usage Mtrs - - - - Roof Drain Ejector/Grind Drink Ftn Serv Sink 1 Soda Disp - - - - - Misc. - Fixtures Use/Nature Remodle tennant space for bakery supply operations***Debit Account of Work , Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Date 11/29/2006 Type Final Inspector Paul Wolf not approved ork not completed at time of inspection. Inspection was completed as requested by Allyn. Notice Type: Telephone Number: DatefTime requested: 11/29/200€O8:48 AM Access: Ready DatefTime: 11/29/?.<J.2! 08:48 AM Requested By: D.R. HANSEN PLBG. o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid -" Plumbing Permit Work Card ;, Job Address 356-386 S KOELLER ST Permit Number 122414 Create Date 11/06/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor D.R. HANSEN PLBG. Category 440 - Industrial-Interior Plan Value $8,000.00 Bathtub Shower Water Softner Wait. St. Shamp Sink - Coffee Maker - - - - - Whirlpool Floor Drain 3 Local Waste Ice Chest FlrlWst Sink - Int Grease Trap - - - - - Lavatory 2 Lndry Tray Clothes Wshr Exam Sink Catch Basin - Ext Grease Trap - - - - Toilet 1 Disposal Bidet Sculry Sink 1 Wash Ftn - RPZ Valve - - - - Res. Sink Dishwasher Beer Tap Hand Sink 1 Urinal - Eye Wash Statn - - - - - Bar Sink Sump Pump Lab Sink Plaster Sink - Standp Rec - Wtr Sewer Mtrs - - - - Water Heater - Classrm Sink - Sterilizer - Surgeons Sink - Ice Maker - Deduct Meters - Site Drain Breakrm Sink Dip Well F Prep Sink 1 Gar Drain - Wtr Usage Mtrs - - - - Roof Drain Ejector/Grind Drink Ftn Serv Sink 1 Soda Disp - - - - - Misc. - Fixtures Use/Nature Remodle tennant space for bakery supply operations***Debit Account of Work , Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Date 11/14/2006 Type Rough In Inspector Paul Wolf approved rail wock I DatefTime requested: 11/14/200!07:50 AM Notice Type: Telephone Number: Access: Ready DatefTime: 11/14/200f 07:50 AM Requested By: D.R. .!:l.!-J':l~~~~~BG. o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid , Plumbing Permit Work Card - .!' . Jbb Address 356-386 S KOELLER ST Permit Number 122414 Create Date 11/06/2006 Owner LANDMARK LIMITED PARTNERSHIP III Contractor DR HANSEN PLBG. Category 440 - Industrial-Interior Plan Value $8,000.00 Bathtub - Shower - Water Softner Wait. St. Shamp Sink Coffee Maker - - - - Whirlpool Floor Drain 3 Local Waste Ice Chest FlrlWst Sink Int Grease Trap - - - - - - Lavatory 2 Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap - - - - - Toilet 1 Disposal Bidet Sculry Sink 1 Wash Ftn RPZ Valve - - - - - Res. Sink Dishwasher Beer Tap Hand Sink 1 Urinal Eye Wash Statn - - - - - - Bar Sink - Sump Pump - Lab Sink Plaster Sink - Standp Rec - Wtr Sewer Mtrs - -~-_.- Water Heater - Classrm Sink - Sterilizer - Surgeons Sink - Ice Maker - Deduct Meters - Site Drain Breakrm Sink - Dip Well F Prep Sink 1 Gar Drain - WtrUsage Mtrs - - - Roof Drain Ejector/Grind Drink Ftn Serv Sink 1 Soda Disp - - - - - Misc. - Fixtures Use/Nature Remodle tennant space for bakery supply operations***Debit Account of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Date 11/6/2006 Type Underground Inspector Paul Wolf approved w/cond. Space address is 374 S Koeller. Owner has stated a letter of intent and procedures will be sent to ISD regarding grease interceptor not being required. I I -----.J DatefTime requested: 11/6/200608:31 AM Notice Type: Telephone Number: Access: Ready DatefTime: 11/6/2006 08:31 AM Requested By: DR HANSEN PLBG. o Reinspect Fee 0 Fee Waived 0 Reinspect Fee Paid ~. ~ OJHKOfH City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh WI 54903-1130 www.ci.oshkosh.wi.us ON THE WATER November 13,2006 Richard Fisher 642 Tholsen Drive Kimberly WI 54136 Ron Detjen Landmark L TD III PO BOX 2366 Oshkosh WI 54903 Site: Plan Number: WI-I09-1106 U Bake 374 S Koeller St. Oshkosh WI 54903 For: Description: Tenant space alterations Object Type: Building only Class of Construction: lIB -1653 Sq Ft.; Srinklered Occupancy: M: Mercantile I Retail The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALL Y APPROVE~. The owner, as defmed in Chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements Key Item(s) I Conditions: . IBC 901.2 Fire protection systems shall be installed, repaired, operated and maintained in accordance with this code and the international fire code. (Construction of new walls may require the addition and or relocation of sprinkler heads to maintain required coverage, and not obstruct spray patterns of fire sprinklers) . IBC 906.1 /IFC 906.3 The maximum travel distance allowed to a fire extinguisher is 75 feet. . IBC 1003.2.11 Means of egress illumination is required to be installed per this section. All paths of egress are required to have adequate emergency lighting to meet the performance requirements of IBC 1003.2.11.3. Existing means of egress emergency lighting is permitted to be maintained in compliance with the code in effect at the time of construction. Any altered path of egress, or new path of egress, and any new emergency lighting being installed is required to comply with current code requirements. . Comm 61.30(3) This review does not include lighting. Comm 63.0001 Prior to installation, lighting plans and calculations shall be prepared in compliance with the code. The plans shall be available upon request. . Comm 61.30(3) I IMC 507.2 This plan review does not include heating, ventilation, or air conditioning. HV AC plans are required to be submitted and approved prior to installation ofHV AC equipment. (:ormn Plan Revi;:w\Wl,j S1 ()nly.doc Page I of2 .. . Comm 61.31(4) Revisions to approved plans. All proposed revisions and modifications which involve rules under this code and which are made to construction documynts that have previously been granted approval by the department or its authorized representative, shall be submitted to the office that granted the approval. All revisions and modifications to plans shall be approved in writing by the department or its authorized representative prior to the work involved in the revision or modification being carried out. A revision or modification to a plan, drawing or specification shall be signed and sealed in accordance with Conun 61.31(1). . Comm 61.50 (4) Supervision. Prior to the initial occupancy of an alteration the supervising professional shall file a compliance statement form SBD-9720 with this office. A copy of the approved plans, specifications, and this letter shall be on-site during construction. All permits are required to be obtained prior to commencement of work. In granting this approval the City of Oshkosh Inspection Services Department reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 10 1.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the number listed below or the address on this letterhead. Bn oe Building Systems Consultant (920) 236-5051 Monday - Friday 7:30 A.M. to 8:30 A.M and 12:30 A.M to 1 :30 P.M. bnoe@ci.oshkosh.wi.us cc: Property file Fee Required $ Fee Received $ Balance Due $ 320.00 320.00 0.00 \\OSHKOSIJlvnSFS\CSF_RS\!Y;;l"n2",;1) Com", Pbn Rt:vic\\-\\VI-li)il-I 1063745 I(odk:,- 51 Bidg. Oniy.d()(; Page 2 of2 .-.~ ~ OJHKOJH ON THE WATER City of Oshkosh Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh WI 54903-1130 www.cLoshkosh.wi.us November 22, 2006 Keith Paul Gartman Mechanical Services 520 W South Park Ave Oshkosh, WI 54903 Ron Detjen Landmark L TD III PO BOX 2366 Oshkosh WI 54903 Site: Plan Number: WI-I09-1106-H U Bake 374 S KoellerSt. Oshkosh WI 54903 For: Description: Tenant space alterations Object Type: BY AC only Class of Construction: lIB -1653 Sq Ft.; SrinkIered Occupancy: M: Mercantile I Retail 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 Key Item(s) I Conditions: . IBC l101.2/ANSI A1l7.1-308.2 & 3 - Mechanical system controls shall be located a maximum of 48" above the finished floor if the floor space allows a forward approach by a wheel chair or if the clear space allows a parallel approach. Caution on location of T-Stat above counter space. . IMC 403.3.4 Balancing Ventilation systems shall be balanced by an approved method. Such balancing shall verify that the ventilation system is capable of supplying the airflow rates required 1:>y Section 403. . IMC 606.2.1 Smoke detectors shall be installed in return air systems with a design capacity greater than 2000 cfm..... .Per the plans submitted the total cfm for the system is 1995, which does not required the installation of a smoke duct detector, however should the balancing of the system to meet IMC 403.3.3 cause this to increase detectors may be required. . Comm 61.31(4) Revisions to approved plans. All proposed revisions and modifications which involve rules under this code and which are made to construction documents that have previously been granted approval by the department or its authorized representative, shall be submitted to the office that granted the approval. All revisions and modifications to plans shall be approved in writing by the department or its authorized representative prior to the work involved in the revision or modification being carried out. A revision or modification to a plan, drawing or specification shall be signed and sealed in accordance with Comm 61.31(1). \\OS1 lKOSTl \.) hFS'.L'5FT<.S\ori,ull1\2006 Cornm Phm H(;\"!(;\,'-'\V I-I O').11()6 374 SK.odkr 51 UVAC f)nJy.doc Page 1 of2 1.. .., . Comm 61.50 (4) Supervision. Prior to the initial occupancy of an alteration the supervising professional shall file a compliance statement form SBD-9720 with this office. A copy of the approved plans, specifications, and this letter shall be on-site during construction. All permits are required to be obtained prior to commencement of work. In granting this approval the City of Oshkosh Inspection Services Department 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 relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the number listed below or the address on this letterhead. RespW ~~ Building Systems Consultant (920) 236-5051 Monday- Friday 7:30 A.M. to 8:30 A.M and 12:30 A.M to 1:30 P.M. bnoe@ci.oshkosh.wi.us cc: Property file Fee Required $ Fee Received $ Balance Due $ 230.00 230.00 0.00 \\OSI lVJ)S! I \1 i:-,FS\USFRS\briann\20(J6 Comm Pbn Re\"iew\WI- i09-1 '106 374 5 Kodkr 5t Page 2 of2 DEC-04.c2006 11: 05 AM P. 02/02 " . Buildings,. HVAC, Compliance Statement 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 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. Generallnatructlons: Prior to the Initial occupancy of new bulldlngsor 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 Information you provIde may be used for secondary purposes [privacy Law, s. '15.04 (1)(m)]. 1. PROJ!;CT INFORMATION: P:;? ~in :;;7110~1ljl with information from your pl~n approvalleller. Transaction ID Number O~ /J >>/;' I1J / - /LJ 9- /iJ b - // Site Number " -/ " )// C ~ //. ~ Site location (number & Blraet) /:2 ~/"""2 ..?9r, ~. /<:7':;P // t!::/ "":>7, ;m'City D Village 0 TOWIl of od.i:c;S' # .countyof,' I . 2. PURPOSE OF THIS STA. TEMENT: (Check eoxA, e, C, or 0 to indicate purpo~ and cemplale an ther# applicable boxes and information. Attach additIonal pages if necessary:) 0 ,.. / / Check those which apply: 0 Building Object ID # ~VAC Object ID # .~#O~ /- L/ " 0 lighting Object ID# , d// -/c:J '7- /I~D --r/ o Partial Completion Description of Portion Completed A) CJ statement of SUbstantial CorflpUance To the best of my knowledge, belief, and based on onslte obaervation, oonstruction of the followIng building and/or HVAC iteme applicable to this project have been completed In substantial compliance with the approved plans and specIfications. D BUILDING/LIGHTING ITEMS 1. SttucturelllystBl'Tl Including submittal and 8f8cllcm of all building oompooents (truaa8fl. precllst, metal buDding, lite.) 2. Fire prol8Ction systems (sprll'lld!!llll, alarms. smoke detectors) dBllIgned, Installed, and \8sted (Including fOlWard flow on baol< flow d8\llces) by appropriately registered profeaaiOl\ale 3. Shsl'tllnd Btslrwlilyenclosure 4. exlts Including ex" and dlrectlonGllIghts ~ 5. F1re-reslstlv$ construction, !!Inclosure of hazards, tiFt! walls, IBbeled dOOfll, elas!!; of HVAC ITEMS conettuetlon. fire stopped penetrlltlana 8. Sanitation system (tolleta, elnkB. drinkIng facllltlee) 1. HVAC system Including flnalt6$t 7. Barrier-free Including Camm 18 elevators and lifts 2. All condlllons of HVAC plsn approval end 8. Energy envelope requirements applicable lIarlanees 9. All conditione of building plan approvEll and appll<:sble varllilnee& The foU.owlng It.me are not In compliance and must be addrea89d: 10, Elderlor lighting & control requirements 11. Interior lighting & conlrol requlrementl! 12, All conditione of lighting plan approval end applicable varl5lncea B) 0 Statement of Noncompliance Due to the follow1ng listed violations, this project Is not ready for occupancy: C) 0 Supervising Professional WUhdrawn From Project (Use A or B ~bpve to indicate project status 85 of this date.) D) 0 Project Abandoned 3, SUPERVISINGxeP F ESSIONAL SIGNATU~/O.R: 2/, A } J;?, / o Building HVAC 0 Lighting .LeL- 77L /V. / ,tU- a Date Name (plell!le prlnl or type) Phone number ;:'ff1J-i{,d&'ttustOlner ID # 9UtJ~ 9 Signature ~