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Home My WebLink About0154573 - Building (build out) CITY OF OSHKOSH No 154573 OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1828-1900 JACKSON ST Create Date 02/26/2013 l ■ Project New store Project Number 20130353 Owner FAIR ACRES LLC/MAJERS LLC Plan Z1-3708-0213 Contractor GANTHER CONSTRUCTION Inspector John Zarate Designer Category 232-Alteration Stores&Customer Service Type of Plan Alt.Level 2 Zoning C-2PD Square Footage Major Occ Mercantile _ Const Class Type IIB Fire Protection • Sprinkled 0 Unsprinkled 1 Sprinkler Design NFPA13 Occupancy Permit Not Required Flood Plain Height Permit Park Dedication #Dwelling Units 0 #Structures 0 ❑ Projection 1 Canopies Signs Use/Nature of Work Comm/Tenant build out*for new store Hometown Pharmacy. HVAC Contractor Plumbing Contractor Electric Contractor Fees: Valuation $35,000.00 Plan Approval $0.00 Permit Fee Paid $537.66 Park Dedication $0.00 Issued By: c�V i..se A t 1.9 13 Date 02/27/2013 Final/O.P. 00/00/0000 ❑ Permit Voided Parcel Id# 1514970200 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 4825 COUNTY ROAD A OSHKOSH WI 54901 - 9618 Telephone Number 426-4774 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. CITY OF OSHKOSH No 154573 OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1828-1900 JACKSON ST Create Date 02/26/2013 Project"White Box"for new store Project Number 20130353 Owner FAIR ACRES LLC/MAJERS LLC Plan Z1-3708-0213 Contractor GANTHER CONSTRUCTION Inspector John Zarate Designer Category 232-Alteration Stores&Customer Service Type of Plan Alt. Level 2 Zoning C-2PD Square Footage Major Occ Mercantile Const Class Type IIB _ Fire Protection • Sprinkled 0 Unsprinkled Sprinkler Design NFPA13 Occupancy Permit Not Required Flood Plain Height Permit Park Dedication #Dwelling Units 0 #Structures 0 C Projection Canopies Signs Use/Nature of Work Comm/White box build out*for new store Hometown Pharmacy. A seperate permit will be required for the finish buildout portion of the project. `$a1 HVAC Contractor _ Plumbing Contractor Electric Contractor Fees: Valuation $35,000.00 Plan Approval $0.00 Permit Fee Paid $537.68 Park Dedication $0.00 Issued By: Date 02/27/2013 Final/O.P. 00/00/0000 [ Permit Voided Parcel Id# 1514970200 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 un erstand t of mentioned information. Signature Date 2-./Z70-3 Agent/Owner Address 4825 COUNTY ROAD A OSHKOSH WI 54901 - 9618 Telephone Number 426-4774 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. `� Safet and Buildin s Division �� Y J ��` ��.. 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 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)]. 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, 10541 N 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 approval letter. Transaction ID Number Z.)- �10�-pZi �Project Name {��i� �l�1uy�� Site Number Site location (number& street)�j2� .�/�C,�C�Il� �- � City ❑ Village ❑ Town of �='j)�KU�Jf�i' County of �(Ilg��(�j 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# ❑ 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, based on onsite observation, construction of the following building and/or HVAC items for this project have been completed in substantial compliance with the approved plans and specifications. �Building/Lighting Items 1. Structural system including submittal and erection of all building components 10. Exterior lighting&control requirements (trusses,precast, metal building,etc.) 11. Interior lighting&control requirements 2. Fire protection systems(sprinklers,alarms,smoke detectors)designed, 12. All conditions of lighting plan approval installed,and tested(including forward flow on back flow devices)by and applicable variances 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 6. Sanitation system(toilets,sinks,drinking facilities) 1. HVAC system including final test 7. Barrier-free including Comm 18 elevators and lifts 2. All conditions of HVAC plan approval and 8. Energy envelope requirements applicable variances 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 a above to indicate pro�ect scatus as of cnis dat D) ❑ Project Abandoned 3. Supervising Professional Signature for: 1 � Building ❑ HVAC ❑ Lighting � {� D "/ ��` �j Name(please print or type) Phone number � Customer ID# GfI�V-1�� Signature SBD-9720(R11/11) � � t ..,"�"`� � r�� '_ �° �� Safe �� ►� �f, ty and Buildings Division �� Buildings, HVAC Com lianc "� p e Statement This form is required to be submitted by the supervising professional(architect, engineer, HVAC designer or electrical designer)observing construction of projects within buiidings 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 locat ordinances. This form must be submitted prior to the plan approval expiration date or anather submittal may be required. Personal information you provide may tse used for secondary purposes[Privaey Law,s. 15.04(1)(m)]. General Instructions: Prior to the initial occupancy of new buildings or additions and the final occupancy of altered existing buildings, submit this complsted and signed form to the municipal building inspection o�ce (refer to the plan approval letter for agency address)and Safety and Buildings Division, 10541 N Ranch Road Hayward,WI.54843. Note: If the review was done by the municipality, the compliance statement oes onty to the municipal building inspector. A copy is not needed by S&B. 9 1. Project Information: Please fill in the following with information from the plan approval letter. Transaction ID Number 21-37p8—p2.1.3 Project Name Horv�etowv� Pkary�,�ac Site Number Site location(number&street) 1-828 JaCkSOn St. �� Y��a9e l� Town of OSI�koSk Counfy of_Wivttnec�ctq0 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 IQ# D HVAC Object ID# ' �Lighting Object ID# O Partial Complefion = Description of Portion Completed A) t� Statement of Substantial Compliance To the best of my knpyvlscige and belief, based on onsite observaiion,construction of the following building and/or HVAC items for this project have been completed in substantial compliance with the approved plans and specifications. t�Building!Lighting Items 1• Strucxural system inGuding submittal and erection of all building componenfs 10. Exterior ligh6ng&control requirements (trusses,precasi,metal building,etc.) 11- Interior lighting&control requirements 2- Fire protedion systems(sp�nklers,alarms,smoke detectors)designed,instatfed, 12, AB conditions of lighting plan approval and tested(induding forward flow on badc flow devices)by appropriately and appHcable variances registered professionals 3. Shaft and stairway endosure 4. Exits inGuding exit and directional lights 5. Fire-resistive construction,endosure af hazards,fire walls,labeled doors,dass ❑ Hyp�� of constructlon,fire stopped penetrations 6. Sanitation system(toilets,sinks,drinking facilities) 7. 8arrier-free induding Comm 18 elevators and lifts 1• HVAC system induding final tesi 8• E�r9Y��ope requirements 2• A��cond'+tipns of HVAC plan approval and 9. Afl cpnditions of building plan approval and applicable vanances applicable variances The fellowing items are not in compliance and must be addressed: B) ❑ Statement of Noncompliance Due Yo the following listed violations,this projed is not ready for occupancy: I �) ❑ Supervising Professianal Withdrawn From Project (use a or B above ro indicate project status as ofmis date.� �) ❑ Project Abandoned 3. Supervising Professional Signature for: ❑ Building ❑ HVAC �Lighting Errk Folske Name(p�ease print or Date `�.��T.13 tYPe) �� Phone number 920•420.279 8 Customer ID# Signature SBD-9720(R 11/11)