HomeMy WebLinkAbout0046661-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
G,::so
N! 46661
TYPE: BLD~TG 0 ELEC 0 PLBG 0 SIGN 0 ZONING r ..L- FLOOD PLAIN~ HEIGHT#:
. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - . - - - - - - - - - - - - - - - - - - -
ADDRESS '3 7 2 .s: co -ko &-1 k r-- PLAN NO. C.l./ -/~ 9 - 8'1 S-
OWNER ~J ~L t..J~/(' ~-tj rJwpl ~~~o--s 4 t .::T1T-
DESIGNER "
USE/NATURE OF WORK f;j, () ,.... ItA 4 L- \I / f:::-,\ ~ /.:5. h. i M. Y--e. ,... " () r- Vd.-L~ J- 4~
=P'" c e ~r- (>/...1/ WL!! '-I
BUILDING CONTRACTOR 'R:- -;:::r A-I & (!'--l~ It. +--
Af,toli.J$(J'I 7~ Sq. Ftffl'-Of 22-CCJ # Rooms
Foundation E,:r':srJ-
g t- j. JIs # Stories
Class of Const. ~
I
Height
Occupancy Permit
t:ey/
HEATING CONTRACTOR
(-R ~ ~l
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
..s 0 ItA. r-
Electric Servo New 0 Change 0 Temp 0
Type
Volts _ Amps_
Circuits
Fixtures
Switches
Receptacles
_BT
_WH
_Sh
~/K.::S' 0 VI
_Disp
_DW
_ WSoft
_DF
_ CBasin
PLUMBING CONTRACTOR
_WC
_FDr
_ L Tub
_SP
_Ur
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_Sink
Other
_ Eject
_SS
/
/1
~~<~/
Permit Fee Paid $ ,-.::.. 0
Date g-'/1. h s-
Park Dedication $
Final/O.P.
"-
FEES: valua'A/:,..s.- 000 -
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~,!J ~""""" .
ADDRESS 57// 6f2.EC}J VA'~ 12d.
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I DATE
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OWNER l-~rdrn~rl( ()l11imif-e.d'~ersfi~REss 3f)~ Se KlJe Iler
DATE ~ - 11- q 5 PERMIT # 4 (0(,0(0 I USE ])l,aVfY1et (" J
W,,-rk cons i. ts of f'{;;1~ 'l teritlr
GENERAL coNT RAC TO R Vn ('/1 t'\ + fenti f\ --I- _ _ __ ___~ _..-
;p hay vYltl c:J '
MASON CONTRACTOR
Width of lot
ZONE
DATE INSPECTIONS
. REMARKS'
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. HArLING ADDRess
Front of lot
CITY HALL
215 Church Avenue
p, 0, Box 1130
Oshkosh, Wisconsin
54902-1130
Il,":
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City of Oshkosh
~
O./HKOJH
August 10, 1995
Landmark Unlimited Partnership III
304 Ohio street
Oshkosh, WI 54901
James Larson
600 South Main Street
Oshkosh, WI 54901
Re: 372 South Koeller Street
Rexall Show Case store
File# C4-129-895
Dear Sir:
Building plans have been reviewed by this office for compliance with important
code requirements. The drawings are stamped "Construction may proceed." All
items that are required to be changed by this letter must be corrected before
commencing that part of the work. This approval is not a Building Permit.
Necessary city permits must be secured before commencing work.
You are hereby advised that the owner, as defined in Chapter 101.01(i) of the
Wisconsin State Statutes, is responsible for all code requirements not
specifically cited herein. Code requirements are set forth in Chapters 50
through 64 of the rules of the Department of Industry, Labor and Human Relations.
The building will be inspected during construction and a final inspection will
be made after completion to insure complete compliance with city and state codes.
The architect, professional engineer, builder or owner shall keep at the
building, as evidence of approval, one set of plans bearing the stamp of
approval.
ILHR 64.02 This approval does not include heating and ventilating. Such plans
are required to be submitted and approved prior to installation of such
equipment.
Sincerely,
Allyn Dannhoff
Director of Code Enforcement
. . 37c ~'O ~oel/er-
BUILDING/STRUCTURE/HVAC PLANS APPROVAL APPLICATION.
Wisconsin Department of Industry. -Complete Botti Sides - I I
Labor & Human Relations I
Safety & Buildings Division
Bureau of Buildings & Structures Scheduling Information -complete
whee ,,"io. to "h,d"', ,,,i,w, :,:~ :0
INSTRUCTIONS: Fill in all applicable data. Caution: Failure to complete the form entirely may cause additional delay.
Submittal of this Plans Approval Application is required for each building. Submit this form with at least 4 sets of plans
which include detailsand data as required by ILHR 50.12. Plans may be submitted to any ofthe plan review offices listed
on the reverse side. Projects are scheduled for review. Please call the selected office prior to submittal. Any components
submitted independently from the building plans must be submitted to the office which did the project's initial review.
1. Owner Information 2. proJ' ect Information 3. Building 9r Structure Designer
InformatIon
Name \...AND MAf!=...\"-
R
UN,UM\,ED
\\
Company Name
S~
Number & Street
~
:30~ b\+\D
City, State, Zip Code
.sT~Ee\
rc-,
crt
t-.I. 0 er: E'
Telephone Number
(41'1) Z3/;.. I D 'tD
Fax Number
("t14 ) --:z.:b iA - t 0 """t~
4. Building History
PrevIOus Owner(s} (if any)
Previous Plan or File No.
Variance No,
Preliminary No,
Other Information (previous use, last submission)
5'\Af'e A-~~RbV~ ".f"O~ ~L06...
5 tt e-LL 'l>LAN M-O,
q~ - \0 ~D\3q""'
7. Building Information
ffl5...
o
o
[j
o
13
Complete Sprinkler - NFPA
Partial Sprinkler - NFPA
Unlimited Area
Fire Alarm
Smoke Detection
Total Number of Stories
l
ZIp .~55 .'llsqh
3 . D D D psf
Building Footprint Area
Soil Bearing Capacity
Oil Presumed
o Verified
10.
BuiJding Occupancy Chapter(s) And Use:
~~ 5'-\ ~^\L
Tenant Name (if any)
~U- 6",DW ~t;: $iO~~
Building Location {number & street}
3"6 .s ' K.O'CLLe-1<. R D
~ City 0 Village 0 Township Of
OS KO$\+
County Of
W I N.I'H:: e.A-~O
Property ID No, {tax parcel no, - contact county}
-8'1
Government Owned 0 Ye.s 0
Govern.ment Leased Or Operated 0 Yes ~No
Designer. Registration #
AMES LARSON A-4424
Design Firm
JAMES E. LARSON ARCHITECT
Number & Street
600 S. MAIN STREET
City. State. Zip Code
OSHKOSH WI 549 1
Contact Person
JAMES LARSON
Telephone Number Fax Number
(414)233-8442 '{414}233-3750
Return Plans To: 0 Owner (llJ Designer
o Other
5.. Construction CI~s~Requested
o 1, Fire Resistive Type A
o 2, Fire ReSIStive Type B
o 3, Metal Fram.e - Protected
o 4, Heavy Timber
o SA, Exterior Masonry - Protected
o SB, Exterior Masonry - Unprotected
Q( 6, Metal Frame - Unprotected
o 7, Wood Frame - Protected
o 8, Wood Frame - Unprotected
If plans do not show compliance with requested
Construction class but are approvable at a, lower
class, do you wish approval atthe lower class?
o Yes 0 No
8. Submittal Request
Review Requested
o Footing/Foundation
gBuilding
o Permission To
Start
o HVAC
o Truss
o Precast
o Structural
o Laminated Wood
o Metal Building
o Joist/Girder
Ei. HVAC Designer Information
Designer
Registration #
Proiect
DNew
&Alteration
o Emergency Power 0 Addition
o Hazard Enclosure 0 ReVIsions
o Use Change
o ILH R 70 Hist Code
o Variance
o Preliminary
o Canopy
o Bleacher
o Tower
GOther
Related Business Systems. Please call th~ r~spective Program for<Iarificatfon'af1d'pla;;"si~"'b;;;Tttarr'eq\lrtements:i
Design Firm
Number & Street
City. State, Zip Code
Contact Person
Telephone Number
Fax Number
9. Supervising Professional Information
~For Building \Sisame As Building Designer
o For HVAC 0 Same As HVAC Designer
Supervising Prof (i different from designer)
414-233-8442
o Elevators (608-267-3S76) includes:
o Passenger elevator meeting ILHR 18 req,
o Freight elevator meeting ILHR 18 req,
o Part 5 Iih (residential type)
o Part 20 Iih (wheelchair lih)
S8D-118 (K 12/92)
o Flammable/Combustible Liquid (608-267.1379)
Will any portion ofthis building be used for
storage or dispensing of flammable /
combustible liquids as covered by ILHR 10?
DYes D{No
. CONTINUE ON REVERSE SIDE - .
o B.oiler/Pressure Vessel (608-266-1904)
o Mechanical Refrigeration/AC (608)266-1904
o Plumbing {608-266-3815)
Sewer:
.2( Municipal 0 Private Sewage System
11.
Calculation of Fees
Area: The area of a floor is the area bounde~by the'exterior surface of the building wallsorthe outside face of
columns where there is no wall. Area includes all floor levels such as subbasements, basements, ground
floors, mezzanines, balconies, lofts, all stories and all roofed areas including porches and garages, except for
cantilevered canopies on the building wall. Use the roof area for free standing canopies. Total area is the
summation of all floor areas. .
Attach a separate sheet if necessary for the calculations below:
Floor Level (specify) Length X
t 6\ -rLR 1,01 ""'b \\ X
X
X
X
X
=
Area
l . BtJD S~. F'
Width
3D' ~ D'\
=
=
=
=
=
Total Area = 'j0l>D .sa f'T
o Project NOT located in certified municipality (go to Fee Schedule Table 2.31-1).
!jg Project located in certified municipality (go to Fee Schedule Table 2.31-2).
(See Fee Schedule for list of certified municipalities.)
o Building and HVAC ................. "0 .. . . o. . .. . .. . . . . .. : .. . . . . . . .. Fee $
Q Building Only ..o.....................o......o......o............~. Fee $ 2..4b, CO
o HVAC Only ........................................................ Fee $
o Revision To Previously Approved Plan ..............0.... 0 . . .. . . . . . . .. Fee $
o PermissionToStart ..........:...............:.....:'.....'.........:. Fee $
o Pre-July 1992 Building Components ...........0..................... Fee $
o Other . . . . . . . . . . . . . . . . . . . . . . .. Fee $
Total Fee =$ 21b.() 0
12. OWNER'S STATEMENT (ILHR 50.11): I requestthat plans be reviewed for compliance with the coderequirements set
forth in Chapters ILHR 50-64 of the rules of the department. I recognize that I am responsible for compliance with
all code requirements and any conditions of plan approval. If this building exceeds 50,000 cubic feet in total volume, I
will retain a supervisin ssional as required by ILHR 50.10 throughout (onstructionto project completion and the
filing of a Completi S me t by the supervising professional. .
Owner's Signature:
ame & Title
Original
13. DESIGNER'S STATEMENT: DESIGN (ILHR 50.07-50.09) ifthis building, following construction ofthisproject, contains
more than 50,000 cubic feet in total volume, plans are required to be prepared, signed, sealed and dated by a
Wisconsin registered engineer or architect (ILHR 50.07(2)). Signatures and seals shall be original.
The department expects, and requires, that the project designerreview individual component submittals for
compliance with the general deSign concept. The project designer, and department, will rely on the seal of the
component designers for compliance with the codes as they apply to their designs.
Total cubic foot volume ofthe building upon completion ofthis project: 0 Less Than 50,000 ~50,000 or Greater
Design loads have been indicated on the plans. 0.0.. . . . . . . . .. . ... . . . .. . .. .. . .. .. . . . . . . . . . . . .. 0 Yes gj. N/A
Firewall schematic plan has been included. 0'...................0............................ 0 Yes .t;:8:N/A
All applicable items required by ILHR50.12 have been included. ....,. J...... 0 ..... ... ........ .Q.Yes 0 N/A
I certify that the submitted plqns were prepared under my supervision, are accurate, and to the best of my knowledge
comply with the applicable codes of the Department of Industry, Labor and Human Relations.
I Signature of Building Designer ( sBut~:~t~l) Date Signed Original Signature of HVAC Designer
~,.
Original Signature of Building Designer ate Signed Name of Component Design Firm
14. SUPERVISING PROFESSIONAL'S STATEMENT: (ILHR 50.10) I have been retained by the owner as the supervising
professional per ILHR 50.10 fc,( the performance or supervision of reasonable on-the-site observations to determine if
the construction is in substantial compliance with the approved plans and specifications. Upon completion of
construction, I will file a written statement with the department certifying that, to the best of my knowledge and
belief, construction has or has not been performed insubstantial compliance with the approved plans and
speci fi cati ons.
iginal Signature 0 Pro essional Supervising The Building Date Signed Original Signature 0 Pro essional Supervising The HVAC Date Signed
4" 2-1 r-
Hayward Office
209 W, 1 st Street
Rt 8. Box 8072
Hayward. WI 54843
Phone (715)634-4870
Fax(715)634-5150
La Crosse Office
2226 Rose Street
La Crosse. WI 54603
Phone (608) 785-9334
Fax (608) 785-9330
Madison Office
201 E. Washington Ave,
P,O, Box 7969
Madison. WI 53707
Phone (608) 266-8735
Fax (608) 267-9566
Shawano Office
1 053A E, Green Bay Stree.t
P,O, Box 434
Shawano. WI 54166
Phone (715) 524-3626 .
Fax (715) 524-3633
Waukesha Office
401 Pilot Court. Suite C
Waukesha. WI 53188
Phone (414) 548-8600
Fax (414) 548-8614
Compliance Statement
....
This form is required to be submitted by the architect, engineer, or HVAC desi~ner (supervising professional) "
observing construction of projects within buildings with total volumes exceeding 50,000 cubic feet and construction
of antennas, towers and bleachers (IlHR 50.10). Failure to submitthis form may result in penalties as specified in
IlHR 50.26 and/or local ordinances.
General Instructions: Priorto 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 also to
DllHR, Safety and Buildings, P.O. Box 7969, Madison, WI 53707
Personally identifiable information may be used for other purposes.
1. PROJECT INFORMATION: (Use the DllHR or municipal project label, or type or print the information.) ,
. Owner Information Project Information
Buildi g Occupancy Chapter(s) & Use
L - L-
A
B
E
L
H
E
R
E
Building Project #
Name and Registration Number ofthe HVAC Supervising Pro essional HVAC Project # \..., -:1
t:).. H.. ~\ f",.~\'-4.~~ oeOCo \-4. 01-';;)... ~
2. PURPOSE OF THIS STATEMENT: (Check BoxA..B, or Cto indicate purpose and comp-Iete any other applicable
boxes and inrormation. Attach additional pages If necessary.)
o Building and HVAC 0 Building Only II HVAC Only
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.
o BUILDING 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 and installed by appropriately registered professionals
3. Exits including exit and directional lights
4. Shaft and stairway enclosures
5. Fire-resistive construction, enclosure of hazards, fire walls,
labeled doors, class of construction
6. Sanitation system (toilets, sinks, drinking facilities)
7. IlHR barrier free requirements
8. All conditions of building plan approval and applicable variances
The following items are not in compliance and must be addressed:
. HVAC ITEMS
1. HVAC system including final test
(llHR 64.53)
2. All conditions oi HV AC 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.)
Date Withdrawn
D) 0 Abandoned
3. SIGNATURES:
Building Supervising Professional
SBD-9720 (R. 01/94)