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Home My WebLink About0157442-Building � CITY OF OSHKOSH No 157442 OSHKOSH COMMERCIAL BUILDING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 401 W 33RD AVE Create Date 08/27/2013 Project Office Buildout Project Number 20130588 Owner SMET INVESTMENTS LLC Plan B61-3857-0813 Contractor KOMOROWSKI DRYWALL LLC Inspector Nicole Krahn Designer Tom Karrels Category 223-Alteration Offices,Banks, Professional Type of Plan Alt.Level 2 Zoning M-3 Square Footage Major Occ Business Const Class Type IIB Fire Protection � Sprinkled � Unsprinkled � Sprinkler Design NFPA 13 Occupancy Permit Not Required Flood Plain No Height Permit Not Required Park Dedication Not Required #Dwelling Units 0 #Structures 0 � Projection Canopies Signs Use/Nature of Work �COMM/OSHKOSH CORP/Building out the existing office space. — I HVAC Contractor UNKNOWN??? Plumbing Contracto� UNKNOWN Electric Contractor UNKNOWN???? Fees: Valuation $28,595.00 Plan Approval $0.00 Permit Fee Paid $810.00 Park Dedication $0.00 Issued By: � Date 08/27/2013 Final/O.P. 00/00/0000 ❑ Permit Voided'i Parcel Id# 1413650000 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 under t nd the afo e entioned i formati�. � �7/�Q�3 Signature Date l AgenUOwner Address 39 2 APPLE LN OSHKOSH WI 54902 - 7364 Telephone Number 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 specifed 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. P O Box 1130 � �ll,y �f Os��s� Oshkosh,WI 54903-1130 � Phone: (920)236-5050 Fa�c:(920)236-5084 Building Permit Application ��.oshkosh.W,.�s Project f � z t� n n Address ��0� W• c�3 � I�v e Applicant Owner ntractor Tenant Other(describe) Owner/ Name �5�'1k0`�� `,o�n O�Gt-�-i'o fl Phone Tenant Address �'�� fQ�o�'1 ��e� Email Contractor Company Name__ _�O(Ylf��1,�51<< vr�W A�� 1,..L_C Phone �i ao -23 s-5 a�� : Contact rJC I Cx�'1 �d(�'lp(D(.�S�� Emai 1 Address ��S a H�p�� ..lA h e : State Credential#'s � ��j��lp� � , Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration# Achitect/ CompanyName �� I�AffQ�S C�nC� '�SSaCiq-�QS PhoneQ2t� ��Zb �`��-10 Designer Contact �0(�'1 1`�Af��S Email Address ��3`t �i q0 MQ ��V� Permit Type Residential Single Family Residential Duplex ommerci Multifamily Industrial Catagory New Addition Alteration Project �U;�� d�;� eX�s�i�i c9'�i-�Ct �,��e Description Mechanical Separate permits will be obtained for the following: Permits Electrical by Plumbing by Heating by Value of Job $ �g ! �j C(S, Q � (Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.) Payment by: Check # 33O Cash Permit Fee Account I certify the above information is co�nplete and accurate. Anv deviations from the above submitted information may require addilional permiu to be obtained. I acknowledge and agree to these terms. Name: ��'�G�'1 �tY1 O f Q(,�s� � (Please print) Date: l Z� !3 Signature: w ��PNNF4 . BLIILDINGS, HVAC, COMPLIANCE STATEMENT SBD-9720 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. 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 • Industry Services 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 Industry Services. Personal information you provide may be used for secondary purposes(Privacy Law, s. 15.04(1)(m)]. 1. PROJECT INFORMATION: Please fill in the following with information from your plan approval letter. Transaction ID Number � ?(��n � "�_3!a Project Name :^� �� ^�a: ,�:,y Site Number Site location (number&street) `�."p �;?, a�� F�,,�� ,City ❑ Village O Town of_N��a:��;p=� County of !��I,^..F.�u;ar'9�,f 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 I 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 specifcations. I, p,BUILDINGlLIGHTING ITEMS , 1. Structural system induding su6mittal antl erection of all building components 10. Exterior lighting 8 control requirements I (trusses,precasC metal building,etc.) tt Interiorlighting&control requiremenis �� 2. Fire protection systems(sprinklers,alarms,smoke detectors)designed,installed, 12. All conditions of lighting plan approval � and tested(including forward fiow on back flow devices)by appropriately and applicable variances registered professionais 3. ShaR and stair.vay enclosure 4. Exits including exit and directional lights 5. Fire-resistive wnstruction,endosure of hazards,fire walls,labeled doors,class ❑ HVAC ITEMS �� of construction,fire stopped penetretions � 6. Sanitation system(toilets,sinks,drinking facilities) 1. HVAC system including final test 7. Barner-6ee including SPS 318 elevators and lifts 2. All conditions of HVAC plan approval and '� 8. Energy envelope requiremen[s applicable variances �' 9. All conditions of building plan approval and applicable variances ' The following items are not in compiiance and must be addressetl: B) ❑ Statement of Noncompliance Due to the following listed violations,this project is not ready for occupancy: �� C) ❑ Supervi5ing Profe55ional WlthdraWn FfOm PfOjeCt (Use A or B above to indicate prqect status as of this date.) D) ❑ Project Abandoned 3. SUPERVISING PROFESSIONAL SIGNATURE FOR: � e�Buildin9 ❑ HVAC ❑ Lighting �gri'�i.;rF„ ki. ;�'p3,;�;��-. • paie Name(please print or type) Phone number �:��:�3-�Z,b,='--F�t'Dt�Customer ID# ��'a i+�� Signature L�^��/ ��1j/�(�/ SBD-9730(R.3.'13) SBD-9720(RAZ�?001)