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Home My WebLink About2012-Building (new facade for building) CITY OF OSHKOSH No 151321 OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 355 N WASHBURN ST Create Date 06/19/2012 Project New facade for existing building - Project Number 20120081 Owner BERGSTROM CHEVROLET CADILLAC OF OSHKOSH Plan X7-3589-0612 Contractor LAKELAND CONSTRUCTION Inspector Nicole Krahn Designer Category 232-Alteration Stores&Customer Service Type of Plan Alt. Level 1 Zoning C-2PD Square Footage IRR Major Occ Const Class Fire Protection 0 Sprinkled 0 Unsprinkled J Sprinkler Design Occupancy Permit Not Required Flood Plain No Height Permit Not Required Park Dedication Not Required #Dwelling Units 0 #Structures 1 ri Projection Canopies Signs Use/Nature of Work COMM/Bergstrom Chevy/Installation of the new facade for the existing building. HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $120,000.00 Plan Approval $50.00 Permit Fee Paid $448.00 Park Dedication $0.00 Issued By: Date 07/23/2012 Final/O.P. 00/00/0000 Permit Voided Parcel Id# 1615060200 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 understand the afore mentioned information. Signature Date Agent/Owner Address 6903 ARROW DR MANITOWOC WI 54220 - 0000 Telephone Number 920-682-5643 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. G P O Box 1130 City of OshkosI G Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax: (920)236-5084 Building Permit Application www.ci.oshkosh.wi.us Project A V/a Ad drr b ess 355 (>Pr) ce Applicant Owner Contractor Tenant Other(describe) Owner/ Name PS,-C•r+pM CAI z-ii Phone Tenant ��11 Address 35.5 ViScShbutnr St• Email Contractor Company Name L ayel And 8rnv01-j ,, LI c. Phone 720'378'07/4 Contact >nbe g Emai rbecl�sc�1'JK ncl b9*b co) Address X963 Arrow 0014v. in9ni+ ,,ce LU I S'/2ZO State Credential #'s — — 11 D 16/c1 Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration# Achitect/ Company Name 6,,e5 Arch. Phone 5.20.7 • Zcly� Designer Contact tee, Email Address 5:0 N. ani,nercial c-rve4 Permit Type Residential Single Family Residential Duplex cmmerciar—' Multifamily Industrial Catagory New Addition lteratiol Project Description I I . .4. . ,7$w .. ' 1C 2! F- --c-- : All J2p1n,4hk2vyO[7- %?& }-h /,,ne goad ) QA.)kun a,/tit $flr3 Mechanical Separate permits will be obtained for the following: Permits Electrical by _ Plumbing by Heating by Value of Job 120,CC[--' (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # 20/0 Cash Permit Fee Account I certify the above information is complete.nd accurate. Any deviations from the above submitted information may require additional permits obtai •d I acknowledge and agre, to these terms. n Name: ..a $P beciac (Please print) Date:(\,l�,/ G3 �l2 �,J"' bJ r Signature: �� rwor Pi ii w Safety and Buildings Division tf 9. Buildings, HVAC Compliance Statem ent 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 volume of 50,000 cubic feet or greater and bleachers (SPS 361.40). Failure to submit this form may result in penalties as specified in SPS 361.23 and/or local ordinances. This form must be submitted prior to the plan approval expiration date or another submittal may be required. Personal information you provide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)1. General Instructions: 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 (refer to the plan approval letter for agency address) and Safety and Buildings Division, 10541N Ranch Road Hayward,WI. 54843. Note: if the review was done by the municipality, the compliance statement goes only to the municipal building inspector. A copy is not needed by S&B. 1. Project Information: Please fill in the following with information from the plan aroyal letter. ,o ,�/ -" Project Name i&,9.571� /7, /,0 47 i iae /� Transaction ID Number ' j Site Number 4' - Site location(number&street) .3y/`/ 114 ,/,a,,C A/ lid / // D City ❑ Village ❑ Town of "s/�0Y� County of G<//.Y4,,4 2. Purpose of This Statement: (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: Building Object ID# n1/1' ❑ HVAC Object ID# ❑ Lighting Object ID# ❑ Partial Completion Description of Portion Completed A) Statement of Substantial Compliance / To the best of my knowledge and belief,Z` items for this project have been completed nssubstantial compliance with the rapproved tp plans following building HVAC Building/Lighting Items 1. Structural system including submittal and erection of all building components 10. Exterior lighting&control control requirements req iremen (trusses,precast,metal building,etc.) 2. Fire protection systems(sprinklers,alarms,smoke detectors)designed,installed, 12. All c ndiiti vsrof lighting plan approval 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,fire walls,labeled doors,class ❑ HVAC Items of construction,fire stopped penetrations 1. HVAC system including final test 6. Sanitation system(toilets,sinks,drinking facilities) 2. All HVAC conditions including plan final approval and 7. Barrier-free including Comm 18 elevators and lifts applicable c ndii variances of HVAC 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: B) ❑ Statement of Noncompliance Due to the following listed violations,this project is not ready for occupancy: C) ❑ Supervising Professional Withdrawn From Project (Use A or B above to indicate project status as of this date.) D) ❑ Project Abandoned 3. Supervising Professional Signature for: D.te l0'ell-/z Building ❑ HVAC ❑ Lighting / '' WI: Name(please prin or type) -��`■_ 9 r19` Phone number �d .? J Customer ID# 2�080 Signature SBD-9720(R11/11)