Loading...
HomeMy WebLinkAboutHVAC�-C. R. MEYER AND SONS COMPANY 895 W. ?Oth Ave. P. O. Box 2157 Oshkosh, W154903 (920)235-3350 Fax (920)2753A19 • • . To: Attn' Department of Commerce Safety & Buildings P.O. Box 71fi2 Madison, WI 53707-7162 Date: 1/14/99 CRMJohNot 98�210 Project No: Your Job No: Project Name: Banner Packaging - Mezzanine Addition Location: 3550 Moser Streel Oshkosh, WI 54901 We Are Sending � Herewith � Under Separate Cover You: ❑ Plans ❑ Shop Drewings ❑ Prints ❑ Specifcations ❑ Correspo�dence 1 Copies of Compliance Statement tBUlding Only) Copies of Copies of From: Covering: Which are : (as checked below) ❑ For Approval p For Correction ❑ ForFinalApproval ❑ For Your Use in Preparing Shop D2Wings ❑ For Fabrication of Your Material Remarks: Reference Trensaction ID Number 146620 to: ❑ ForYourUse � For Files and Distribution ❑ For Field Use ❑ For Sending Us a Quotatlon on your Material shown by C. R. MEYER AND SONS COMPANY By; KenneM Kraase / � _� Packaging Mezzanifie Addition � x /Buiidings, HVAC, Lighting Compliance Statement 7nis form is required to be submitted by the supervising professional (amhitect, engine?r, HVAC designer or e�ectdcal dzsigner) observing construction of projects within builtlings wim total arezs exce=ding Spp00 cubic feet and construction • of antennas, towers, and bleachers (ILHR 50.10). Failure to submit this form may resWt in penalties as specifed in ILHR 5026 andlor local ordinances. • General lnstructions: Pnor to the initial occupancy of new buildings or additions antl the final occupancy of altered ex�sting buildings, submit this completed and signed form lo: • Th= municipal buiiding inspection office and . Safety and Buildings, P.O. Box 7162, Madison, WI 53707-7162 ?ersonal intortnation you provide may 6e used for secontlary puryoses [Pnvacy Law, s. �5.04 (�)(m�]. 1. PROJECT INFORMATION: Please fiil in the following with infortnation fmm your plan approval lettes. Transaction 1� Number 146620 Site Number 584936 Site location (number & street) a55o Mo.�er Screec � Giry ❑ Vifiage ❑ Town of Oshkosh County of winnebago 2. PURPOSE OF THIS STATEMENT: (Ch=ck Box A. B. C, or D to intliwte purpose and compleL= any other applicaCle bozes an0 infortnation. ACach additional pag=s if neressary.) Check Ihose whith apply: � Building Obj=_ct 10 � 424262 ❑ HVAC ObjeC ID m � ❑LightingObj_ctiD: ❑ Partial Completion - Descnption of Partion Campleletl , A) � Statement of Su6stantial Compliance 10 the be5t of my knowletlge, belief, and based on onske observation, tonstruqion of the foliowing building and/or HVAC items applicable to this p*ojed have been comD�etetl in su0stanfia! compliance witn ihe apDmved plans and sQecifications. � 9UILDING ITEMS ' t SiruRUral system including submittal antl ere!tion of all building componeMS (tnsses, precast, metal builtling, etc.) Fire pmi_caon sys;ems �spruueiers, alarm:, srtwae aee_Qors� cevgnetl. � installetl, and test_d (inGUding tareard flow on back flow tlevices� by zpprcpna�=iy regs;ara, pries5mnais 3. Shaft and sfairway enUosure 4. Ezits mcludi(y exit antl directional lights 5. Fire-resistive constru�tion, endosure ot hazartls, fire walls, Iebeietl tloors, Gass of wnstruction 6. Sanita6on system (loilets, sink5, dnnking facilities) ' '"_- _ - '„'.c�� -nw_�e.o�o��o��..���.a B. ILHR 63 e�ergy envelepe 9. All wntlitions of builtling plan approval and aAP�icahle vanances The following items are net in cempliance a�d must be a6dressed: _ �Bj � SWtementofNontompliance Due lo the folyowing listetl violalions, ihis project Is not rea0y tor occu0anry: ❑ HVAC IT'cM5 1. HVAC 5ystem incfuding fnal test (7LHR 64.53) 2. All wnditions ot HVAC plan approval and applicable vanances ❑ LIGHTING ITEMS 1. Exierior Ilghting 8 rontrol requirements 2. Intenor lighting & contml requirements 3. All conditions o/1ighEng pla� aQpmval and applicable vanences C) ❑ Supervising Professfonai wthdrawn From Prajett (Use A ar B a6ove to indirate project staws as of this date.) D) ❑ ProjactAbandoned � 3. SUPERVISING PROFESSIONAL SIGNATURE FOR: � Building ❑ HVAC ❑ Ligh6ng Kenneih W. Kraase Oat January L 1999 Name (piease ptlnt or rype) � / Phonenumber 920-235-335(CustomerlD# 640897 Signature �� seo-s�m �aos»8)