HomeMy WebLinkAbout0143744-Building CITY OF OSHKOSH No 143744
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1399 W SOUTH PARK AVE Owner LESLIE C /FAITH I DRAVES Create Date 10/19/2010 •
Designer Contractor SUN COMFORT INC
Category 131 - Multi - Family Addition Plan
Type • Building O Sign O Canopy 0 Fence 0 Raze
Zoning Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection
Finished /Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab O Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication # Dwelling Units 0 # Structures 0
Use /Nature Multi /Sun Room -144 square foot sun room addition. OK to issue per conditional approval letter dated 10/18/2010. Verify value. KC
of Work
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $18,500.00 Plan Approval $0.00 Permit Fee Paid $142.00 Park Dedication $0.00
Issued By: Date 10/20/2010 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 1307310211
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
I have read and uu rstand th e mentioned information.
Signature G c 0 / l .. Date / 0 '010 o?bJo
`1 rj —` Age ct&ne
Address 1930 VAN DYKE RD APPLETON WI 54914 - 0000 Telephone Number 380 -5840
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
73O —a
103o- -13
City of Oshkosh
Inspection Services Division
P Boh 1
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 Of HK01H
Fax: (920) 236 -5084
Building Permit Application ON THE WATER
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account 1l
JOB ADDRESS / 3 9 i. ?AlK/< /l
OWNER Z 27 d R 1 / 7 s
CONTRACTOR S v /W C p M F v R 7
I am the: piCOwner OR ❑ Contractor,
USE CATEGORY
fingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
Work being done:
,Addition dPorch/Patio ❑ Driveway/Parking
❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure
❑ Handicap Ramp ❑ Hot Tub /Spa ❑ Internal Remodeling
❑ Sign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace
❑ Swimming Pool ❑ Wrecking Permit
❑ Other
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
• Full description of work being done: ,',t n/ , O o to / q-pp ; fl 0 A / B e1 v/37;p "n7,
, • A., , � - 0 A , •
/■,f E ?R NT LI f 'EP c
Any work not included in this application is not permitted.
Value of the job $ ( D J 00 (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained. I acknowledge and agree to these terms.
Name: J ES 4L4' e . / , /4 f/Ey
(Please pr' • '
Signature: 111■1 -
Date: 1p P 3 — o 0 /
3/02
SUNSPACE SPECIFICATION SHEET
Customer: Sun Comfort Order Date: Mar 18, 2010
Tag Name: draves Page 1 of 3
Room Specifications Room Layout
12' 0" Projection x 12' 0" Width
Room Style: Gable
Room Type: Model 200
Sidewall Height: 99" Incl. Roof
Frontwall Height: 123" Incl. Roof
Framing Colour: White
Ext. Panel Skin: White Alum. Stucco
Int. Panel Skin: White FRP
Kneewall: 7" Solid Panel
Transom Style: Clear Vinyl
Cut Pitch: Yes
Floor Specifications
12' 0" Projection x 12' 0" Width
Thickness: 4-1/2" __ —''' '
Ledger: 3"
Sides: 3" Roof Layout
Front: 3" - II , -i�
Joint: 0 -3/4"
Floor Has Metal Vapour Barrier I
II
I
Roof Specifications II
2 @ 7' 6" Projection x 13' 0" Width II ,,
Roof Type: Pressure Cap I I
II
4" x 1 lb x 0.024"
Int. Panel Color: White _.,.� -__ _ I�
Ext. Panel Color: White „ II
Gutter Color: White II
Stripe Color: "_ = --II
Downspout Color: White _ --
# of Downspouts: 2
Soffit Size: 0"
Windows and Doors
Window Type: Spring
Window Color: White
Vinyl Tint: Smoke Grey
Screen Type: 18/16 Mesh _____ -__
e tWall: V4T Entry Door — , < Li (J 44. /-
36" x 80 ", LHH, Outswing , 7" Kneewall,
Smoke Grey, Antique Brass Hardware, Vinyl
Transom
This Room is to be installed on a House
SUNSPACE SPECIFICATION SHEET
Customer: Sun Comfort Order Date: Mar 18, 2010
Tag Name: draves Page 3 of 3
Wall Specifications
Right Wall
C18 90° Corner \ ._ _ ,
F19 2" Solid Wall
W20 43 -1/4" x 72 -3/8" Spring .I I –' ■■
Clear Vinyl Transom
W21 43 -1/4" x 72 -3/8" Spring 95" ER I, .
– _ _ In W22 ■I ■ 95"
Clear Vinyl Transom MIS I 43 -1/4" x 72 -3/8" Spring
Clear Vinyl Transom I —_ 1
F23 2" Solid Wall 11 1 7f (_, 7" \
S24 Starter C18 W20 W21 W22 S24 '
`I. Right Wall 144" - `I.
F 1
f j
/' 4/ j n ` � J .` l
\
SUNSPACE SPECIFICATION SHEET
Customer: Sun Comfort Order Date: Mar 18, 2010
Tag Name: draves Page 2 of 3
Wall Specifications
Left Wall
S1 Starter --
F2 2" Solid Wall
W3 43 -5/8" x 72 -3/8" Spring ■ - j ■
Clear Vinyl Transom
BH4 Box Header 95 �■ .. 95
D5 Vinyl 4 Track Entry Illa — 1 ■
Door
Vinyl Transom MI L W
BH6 Box Headerr i ' r ,J
W7 43 -5/8" x 72 -3/8" Spring S1 W3 BH D5 BH W7 Cs
Clear Vinyl Transom Left Wall 144" _ ,,
F8 2" Solid Wall _ � - - -- t (?
C9 90° Corner
I® Left Gable L
C9 90° Corner 95 IL �. r 119"
F10 2" Solid Wall
W11 29 -7/8" x 72 -3/8" Spring ..
Clear Vinyl Transom
W12 29 -7/8" x 72 -3/8" Spring iU i•
Clear Vinyl Transom \ !�• 7"
S13 Starter C9 W11 W12S13
Left Gable 69 -3/4"
Gable Post
4 -1/2" Existing Wall —�_
Right Gable 11111
119"
S14 Starter .! 95"
W15 29 -7/8" x 72 -3/8" Spring ..
Clear Vinyl Transom :�
W16 29 -7/8" x 72 -3/8" Spring
Clear Vinyl Transom �� '7" ,
F17 2" Solid Wall S14W15 W16 C18
C18 90° Corner Right Gable 69 -3/4"
Wisconsin Department of Commerce
ID:
APPLICATION FOR REVIEW BUILDINGS, HVAC, LIGHTING, A
FIRE AND COMPONENTS — SBD -118 Asssigsig need d
Reviewer:
Personal information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m), Stet.] Assigned Office:
Reviewer Start Date *:
For pre - scheduling of building HVAC, and fire plans, use the Enter Previous Related Trans. ID if applicable:
electronic online request for commercial building plan
appointments found at http: / /commerce.wi.gov /SB /SB- (If no previous related transaction is provided, plan review will be based on the current code, except for
DivPlanReview.html #.This form is to be used only for mailing or revisions. If a previous related transaction is entered and the parent building approval transaction has
dropping off plans without an appointment, or if you are not expired, you may elect below to use the code in effect at the time of that approval for follow -up
scheduling a Revision or Lighting via FAX (see Box 13 for revision, HVAC and fire protection submittals related to that building approval. Note that this
further information). Check our website at submittal's approval would then expire no later than the parent building approval.)
http: // commerce .wi.gov /SB /SB- DivForms.html for the most ❑ Please review under the code in effect at the time of the parent building approval.
current version of this form. We may re-distribute plans to Circle your choice of office: 1.Next available appt In any office 2. Green Bay
another office if needed to reasonably balance turnaround 3. Hayward 4. LaCrosse 5. Madison 6. Waukesha
times. You may monitor the status of your plan at: FOR SCHEDULING REVISIONS BY FAX - Enter date plan will be in our office:
http://commerce.wi.gov/SB/SB-DivReviewStatusSearch.html
Where should we send the Appointment Confirmation: ❑ E -mail: ❑ Fax
1.a. Type of Submittal or Service 2. Occupancy Type Additional Non - Accessory 3. Construction Information
Requested (check all that apply) Major Use — Check Use with Occupancies — Circle All Construction Class — Circle One
( ) New the Greatest Floor Area that Apply) IA IB IIA IIB IIIA IIIB IV VA VB
( )Alteration — Level: ❑ 1 ❑ 2 ❑ 3
ddition /Alteration — Level: ❑ 1 ❑ 23 ( ) A Assembly Al A2 A3 A4 A5 4/ ( ) Approval Extension Area (project area, include all levels): — f sq ft
( ) B Business/Office B
f
( ) Revision ( ) E Educational E Number of Floor Levels Ohf
( ) Footing & Foundation Plans Only ( ) F Factory/Industrial F1 F2
() Permission to Start ( ) H Hazardous H1 H2 H3 H4 H5 Total Buildi Volume is less than 50,000 Cu. Ft.
( ) Follow Up of a Denial Within 8 Months ( ) I Institutional /Daycare/CBRF 11 12 13 14 g
( ) Preliminary Consultation (contact
Yes Volume
reviewer before scheduling or submitting) ( Mercantile/Retail
ResidentiaelRetail M
l R1 R3 R4 Seismic Review Threshold (circle one)
( ) Structural Framework — Shell Only ) S Storage 31 2 ( e one
() Multiple Identical Buildings (see box 5) (1 U Utility /Mist U 1. N 3. Non-Structural and greater than story 2. A or 1 story
Number of Buildings Alterati on
4. Project Information — Fill in all known information Site Number If Known
b. Objects Submitted for Review as
Project/Site Name
Current Review (check all that apply)
Building Tenant name or building designation
( ) HVAC Previous Tenant Name
( ) Lighting & Emergency Egress 0
( )Fire Suppression (see box 7) Number & Street AA ∎ _ L �A It. V = /�
( ) Fire Detection /Alarm (see box 7)
County U s g //
t p Cityp V illage () Town () of /N
Other Projects (Stand Alone from above) 5. Identical Buildings { (N * : Complete a sep application for each non-identical building)
( ) Bleacher
Building/Facility Name/Designation
( ) Canopy g ty 9 Building /Facility Address
•
( ) Kitchen Exhaust Hood
( ) Membrane Construction
( ) Rack Supported Storage Building
( ) Elevated Pedestrian Access
c. Structural Component Plan(s) which
accompany this current plan submittal Designer's Project Number (If Applicable) Add Add'I Sheets if Needed
(check all that apply):
( ) Roof Truss 6. After plans are reviewed, please: (check all that apply) *Refers to customer number from
( ) Metal Bldg below
( ) Floor Truss ( ) Fire Escape ❑ CaII Customer 1, 2, 3, 4 (circle number)* ❑ Mail plans to customer 1, 2, 3, 4 (circle number)*
( ) Steel Girder ( ) Precast Plank ( ) p
( ) Laminated Wood ( ) Precast Wall ❑Hold plans for pickup by designer designated agent
Designer Information (Customer 1) First Time Submitter _ Yes No Designer Information (Customer 2) First Time Submitter _Yes No
First -me Last Na e Customer Number First Name Last Name Customer Number
_i, Ii Ji. /I Li /i.
• n W� ' Company Name
A•n ress Address
City '1 State f Zi + (9 lilts) City
Q rj(/ U State Zip+4 (9 digits)
Poe umber a co de) Fax E - 'I ���, one N tuber (area code) Fax
Check others if applicable E -Mail
'l3 0 • I code) GrZ4 -.7.- -cL110 gig urAr - "
eck others if a �rcable
esigner oIdg _HVAC,_ Lighting _Fire Alarm _Fire Suppression ( ) Designer of Bldg HVAC, _Lighting _Fire Alarm _Fire Suppression
Designer # Designer A/E #
( ) Supervising Professional A/E # of _Bldg HVAC ( ) Supervising Professional A/E # of _Bldg _HVAC
Property Owner (not lessee) Information (Customer 3)
First Name Last Name rl Other (Custome� Payer
Customer Numbe Fi rst Name I er II to stomer Number
Company Name Company Name
Address Address AUG 1 7 2010
City State Zip+4 (9 digits) City DEPAK 1 MlNrTtOF Zip+4 (9 digits)
COMMUNITY DEVELOPMENT
Phone Number (area code) Fax E -Mail Phone NumberlAISP SERVICES DIVISION
E -Mail
SBD -118 (R. 06/2010)
7. Fire Protection (Check System Type as Applicable) Submitter Comments or Requests (Optional)
Fire suppression and alarm plans are required for certain occupancies. See building approval
letter or contact us for requirements. When required, the plans for fire sprinkler, fire detection ,
and fire alarm must be submitted to the Waukesha office. Please include the original building
transaction number on the second line of page 1, upper right hand box. Do not submit fire
suppression or fire alarm plans together with building or HVAC plans unless they are
scheduled for the Waukesha office. A separate application form and plan sets are required.
Blda Plans must also include this information to determine allowable Blda Area / Heights
FIRE ALARM FIRE SUPPRESSION
( ) Complete ( ) Partial %None ( ) Complete ( ) Partial one
Type: ( ) Wet ( ) Dry () re- ction/Deluge
Type: ( ) Automatic Detection ( ) Manual Alarm ( ) Anti- Freeze ( ) Manual Wet
NFPA Fire Suppression Standards used
Monitoring Type: ( ) 11 ( ) 11A ( ) 12 ( ) 13 ( ) 13R
( ) Central Station ( ) Proprietary Supervision ( ) 14 ( ) 15 ( ) 16 ( ) 17 ( ) 17R
( ) Remote Supervision ( ) Protected Premises ( ) 17A ( ) 20 ( ) 22 ( ) 24 ( ) 750
( ) 2001 ( ) Other
8. Other Potential Plan Submittals Required For A Project?
• Petition for Variance — Submit form SBD -9890 - Erosion control & stommwater management under Comm 6
• Plumbing and private sewage systems under chapters Comm 81 -85 - Boiler & pressure vessels under Comm 41
• Elevators or Escalators under chapter Comm 18 - Mechanical Refrigeration under Comm 45
• Swimming Pools or other Aquatic Centers within a Commercial /Public Facility under chapter Comm 90 - There is no state electrical review under chapter Comm 16
• Tank storage of 5,000 gallons or more of flammable or combustible liquids under chapter Comm 10
Contact S &BD for individual submittal requirements for all of the above.
Department of Health enforces Building Code Requirements, including Plan Review, for Hospitals and Nursing Homes. Daycare facilities must meet building codes prior to
their licensing.
For licensing of Hotels, Motels, Restaurants, Pools, Campgrounds and Bed & Breakfast establishments contact the WI Environmental Sanitation Section at (608) 266 -2835.
The Wisconsin Permit Center at 1- 800 -435- 7287 may be able to help you with other state permit requirements.
Note: Be aware that State Plan Review & Approval is separate from Local Permits. Always check with the local municipality and county for their
requirements.
9. Required Signatures
a) SUPERVISING PROFESSIONALS If building will be 50,000 cu ft or greater (Comm 61.40) I have been retained by the owner as the supervising professional per
Comm 61.40 for the performance of the 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 and municipality certifying that, to the best of my knowledge
and b= '
' - f, construction has or has not been performed in substantial compliance with the approved plans and specifications. In the event that I am no longer associated
with . proje. I will file a compliance statement (SBD -9720) no ' ing the Department as such and indicating the current status of compliance.
ature �t/^II�/rp�/ Print 1
,
�. -r : A • - G a V • c Building ( ) HVAC Date
( ) ( ) HVAC Date
I NOTE: Building Supervising Professional s al responsible for supervision of the Lighting & Fire Suppression / Mann Installation (If Applicable)
b) COMPONENT SUBMITTAL The Department requires that the project designer review 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.
Original Signature of Building Designer Date Signed Name of Component Fabricator
c) Optional Service - Permission to start requested — (Be sure to check box under Building Submittal Type on front page)
( ) As the owner, I request to begin footing and foundation work PRIOR to plan review approval. I agree to make any changes required after plans have been
reviewed, and to remove or replace any non -code complying construction. I will not permit construction above the foundation until approved plans are at the site.
(Additional $75.00 Fee per building) Request is for the following buildings:
Owner's Signature Date
d) ( ) Invoice Designer, who will be personally responsible for payment.
Designer Signature
10. Statements of Owners and Designer
a) OWNERS Statement The owner indicated on page 1 requests that plans be reviewed for compliance with the code requirements set forth in
Chapters Comm 60 to 66 of the department. The owner recognizes responsibility for compliance with all the code requirements and any conditions of
approval. If a building is 50,000 cubic feet in total volume or greater, plans are required to be prepared, signed, sealed and dated by a Wisconsin
registered engineer or architect [Comm 61.31). Signatures and seals affixed to the plans shall be original.
b) DESIGNERS Statement (Comm 61.20, 61.31(1), and 61.40) The designer indicated on page 1 of this form is responsible for preparing or
supervising the preparation of the plans to the best of his /her knowledge to comply with the applicable codes of the Division of Safety & Buildings for
this submittal. If a building, following construction of this project, contains more than 50,000 cubic feet in volume, plans are required to be prepared,
signed, sealed and dated by a Wisconsin registered engineer, architect, or designer [Comm 61.31(1)]. Signatures and seals affixed to the plans shall
be oriainat. Liahtina Plans may instead be desianed & submitted by the master electrician installina the system.
SBD -118 (R. 06/2010)
11. Fee Calculation Instructions
FEE SCHEDULE SUMMARY: WISCONSIN BUILDING CODE
Calculate appropriate fee on page 4 and enter total on Page 4.
I. Building heating and ventilation. fire alarm and suppression plans. Fees relating to the submittal of all building and heating
and ventilation plans (new, addition, alteration) and fire alarm and fire suppression plans shall be computed on the basis of the total
gross floor area of each building, area of addition or area of alteration and shall be determined in accordance with Table Comm
2.31 -1 or Table 2.31 -2
Note: Comm 2 provides for a partial fee refund if a plan action has not been taken within 15 days of receipt of all required information.
Table 2.31 -1
Plan Review Fees for
Buildings Not Located in Municipalities That Perform Inspections as an agent of the Division of Safety & Buildings
Area (Square Feet) Building Plans HVAC Plans Fire Alarm System Fire Suppression
Plans System Plans
Less than 2,500 $300 $180 $50 $50
2,500 - 5,000 350 250 100 100
5,001 - 10,000 600 350 150 150
10,001 - 20,000 800 450 200 200
20,001 - 30,000 1,200 600 250 250
30,001 - 40,000 1,600 900 400 400
40,001 - 50,000 2,100 1,200 550 550
50,001 - 75,000 2,900 1,600 800 800
75,001 - 100,000 3,600 2,200 1,100 1,100
100,001 - 200,000 6,000 2,900 1,400 1,400
200,001 - 300,000 10,500 6,700 3,300 3,300
300,001 - 400,000 15,500 9,800 4,800 4,800
400,001 - 500,000 18,500 12,000 6,300 6,300
Over 500,000 20,000 13,500 7,100 7,100
Table 2.31 -2
Plan Review Fees for
Buildings Located in Municipalities That Perform Inspections as an agent of the Division of Safety & Buildings
This table may be utilized for projects in municipalities that are delegated to perform inspections of the object type(s) that you are
submitting as a certified municipality and /or agent of the Department of Commerce. Reduced fees do not apply to state owned
buildings. Check our website home page at http: / /www. commerce. wi. gov /SB /SB- CommBldgsDeleMunis.html, or call 608 - 266 -3151 for
the current list.
Area (Square Feet) Building Plans HVAC Plans Fire Alarm Fire Suppression
System Plans System Plans
Less than 2,500 dr $150 $30 $ 30
2,501 - 5,000 300 200 60 60
5,001 - 10,000 500 300 100 100
10,001 - 20,000 700 400 150 150
20,001 - 30,000 1,100 500 200 200
30,001 - 40,000 1,400 800 350 350
40,001 - 50,000 1,900 1,100 500 500
50,001 - 75,000 2,600 1,400 700 700
75,001 - 100,000 3,300 2,000 1,000 1,000
100,001 - 200,000 5,400 2,600 1,200 1,200
200,001 - 300,000 9,500 6,100 3,000 3,000
300,001 - 400,000 14,000 8,800 4,400 4,400
400,001 - 500,000 16,700 10,800 5,600 5,600
Over 500,000 18,000 12,100 6,400 6,400
NOTES:
A. Plan entry fee of $100.00 shall be submitted with each submittal of plans to the department in addition to the plan review and
inspection fees.
B. Lighting Plans and Calculations will be reviewed at no additional cost if submitted with the Building Plans. A fee of $75 will be
charged if submitted with the HVAC Plans. A Fee of $75 plus the $100 submittal fee (Total $175) is required for all Lighting Plans
submitted separately. Lighting Energy Plans / Calculations and Egress Lighting Plans / Calculations must be submitted together.
C. A fee reduction may be taken for plans involving multiple identical buildings located on the same site and submitted at the
same time: The fees for the submittal of building, heating and ventilation plans for the first building shall be determined in
accordance with the appropriate Table 2.31 -1 or 2.31 -2 on the basis of the total gross area of one building. The fee for each of
the remaining identical buildings shall be computed on the basis of an area of less than 2,500 square feet.
SBD -118 (R. 06/2010)
12. CALCULATION OF FEES
Determine Project Area: The area of a floor is the area bounded by the exterior surface of the building walls or the outside face of
columns where there is no wall. Area includes all floor levels such as subbasements, basements, ground floors, mezzanines, industrial
equipment platforms, balconies, lofts, decks, 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 project area is the summation of all floor areas that are
part of this project. Attach a separate sheet if necessary for the calculations below:
Floor Level (specify) Length X Width = Area
X =
X =
X =
X =
X =
Total Project Area = I%
B. Determine Fee Table: Determine the appropriate fee table based on the project location.
C. Compute Total Fee
• Building Fee (from table) IS .00] + [No. of Add'I identical Bldgs X Min. Fee $ .00] = $ .00
• HVAC Fee (from table) IS .00] + [No. of Add'I identical Bldgs X Min. Fee $ .001 = $ .00
• Fire Alarm Fee (from table) IS .00] + [No. of Add'I identical Bldgs X Min. Fee $ .00] = $ .00
• Fire Suppression Fee (from table [$ .00] + [No. of Add'I identical Bldgs X Min. Fee $ .001 = $ .00
• Miscellaneous Fee No. of Buildings x $250.00 $ .00
(plans submitted within 8 months of denial, separate footing /foundation, independent bleacher plans
more than 10 feet apart, etc)
• Permission to Start Construction No. of Buildings X ($75.00) $ .00
• Revision to previously reviewed, but not denied, plans No. of Buildings X ($75.00) $ .00
(This includes submittal of revised plans, within 30 days, after an additional information/hold action)
• Additional number of plan sets No. of Plan sets in excess of 5 X ($25.00 /set) $ .00
• Components $ .00
Trusses, precast, metal bldg, joist girders, etc. If submitted with or as a follow up to a current bldg project,
fee is only the minimum $100 submittal fee. If submitted as a stand -alone project or submitted following
final inspection of the building, fee is $250 plus the $100 submittal fee.
• Other (Lighting plan separate from building plans $75) $ .00
• Submittal Fee (required for each and every separate submittal of choices above) $ 100.00
• Additional sets of approved plan sets requested after plan approval No. of Plan Sets X ($25.00) $ .00
• Plan Approval Extension ($120.00) $ .00
MAKE CHECKS PAYABLE TO DEPT OF COMMERCE. ATTACH CHECK TO PAGE 1 Total Amount Due $ - ' j
IF DESIGNER WISHES TO BE INVOICED, PLEASE COMPLETE BOX 9d ON PAGE 2 Revenue Code 7648
13. Appointment, Scheduling Information, and Plan Submittal Checklist.
To schedule for other than revisions — do not use this form. Instead you can utilize our 24 -hour web scheduling site located at
http: / /www. commerce. wi.gov /SB /SB DivPtanReview.html to reserve an appointment date while you are still working on the plans.
For Revision or Lighting appointments fax this form to 877 -840 -9172.
Web Scheduling allows you to view the next available appointment in any office and select an office that best fits your timeframe.
You will receive a completed application form with an appointment date, transaction ID number, assigned reviewer, and required
fees based on what you entered. Pre - scheduled plans must be received in the office of the appointment no later than 2 working
days before the confirmed appointment.
Check our Website at http: // commerce. wi. qov/ SB /SB- CommBldgPlanRevInfo.html. You may email technical code questions to
bldgtech or fax to (608) 283 -7403.
Madison S &BD Hayward S &BD LaCrosse Area S &BD. Green Bay S &BD Waukesha S &BD
201 W Washington Ave 53703 10541N Ranch Rd 3824 N Creekside La 2331 San Luis Place 141 NW Barstow St.
PO Box 7162 Hayward WI 54843 Holmen WI 54836 Green Bay, WI 54304 4'" Floor
Madison WI 53707 -7162 Waukesha WI 53188 -3789
715- 634 -4870 608 - 785 -9334 920 -492 -5601
608- 266 -3151 262 -548 -8600
TYY Contact Through Relay Fax (for sending questions or Fax (for sending questions or Fax (for sending questions or Fax (for sending questions
additional info to reviewers) additional info to reviewers) additional info to reviewers) or additional info to
Fax (for sending questions or 715- 634 -5150 608 - 785 -9330 920 - 492 -5604 reviewers)
additional info to reviewers)
262-548-8614
608 - 267 -9566
SBD -118 (R. 06/2010)