HomeMy WebLinkAbout0045334-Building (addition - indoor volleyball courts) ��y
. HKO H N° 45334
CITY OF OS S
� � PERMIT — APPLICATION AND RECORD
► � �p �
TYPE: BLDG�RTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING ��— FLOOD PLAIN HEIGHT
�- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS c��S ,v • liv�t.<���3 t-11 PLAN NO.�3'"P�1=�p�S-
OWNER ��� ` ea- P-�`
DESIGNER
USE/NATURE OF WORK e�`�' ^- /�s �S^8
p��� �s F � ��.-� �,����/ �,o.�.� .
. � � � � �� � -30�P
BUILDING CONTRACTOR ���� � �'`-
Size`�� � �rS��t. L�g�� # Rooms '� # Stories Height �
Foundation �Ll2�,Cl'-� Class of Const.� Occupancy Permit��
HEATING CONTRACTOR �
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR�
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR ?
_BT —WH _Disp —WSoft —CBasin
._Lav —Sh _DW —DF —San. Sewer
_WC —FDr —SP —Ur —Storm Sewer
._Sink _LTub _Eject —SS —Water
Other
FEES: Valuatio �' rmit Fee Paid $ � Park Dedication $
ISSUED BY Date � Final/O.P.
In the performan of t s work I agree to perform all work pursuant to rules governing the described constructi9n.
/
SIGNATURE �" ����
AGENT/OWNER --� DATE
ADDRESS ����,3SS,S :
TELEPHONE�
�
� • -
�
� • ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: v � � � � ��s �•�+—l� ZONING C Z'"
PROPERTY OWNER/CONTRACTOR:
' CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
f�Z o O S �, ��'�-�'��
COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use �jr t!i�r/b /S�/�G/��iQ- ��4, ` 7G� �
Lot Width ��l�t �fB.f �li �I�Iv/`�`�, S/�/k� `/��/K�>
Lot Area _C,
Lot Area Per Family M
Floodplain �� ~� �Q��d� !J GG7J�L4.d ,�J .
Front Yard � (y,tA1'v�.j/!l�IG� �/f'l� f�i✓d t/0l•G{,� `�
Front Yard Side Street ���,3 Q{ f � l
Rear Yard • � Z`�' �" 9 ,T�i��+ �D�'L"'
Side Yards ��( s���� � a f�j-��, S��f, �
Buildi /�e�,�
kin Standar � ��f /�+/'�/��dd� �C T..L C�,�L(,w���
Off-Street Loading Standards �� �� �aL�� �
Vision Clearance Y �� �i�l� Z ,�X�f 1v
Transitional Yard Standards �-��,r- ���� �� �'f",�, ��
Landscape Standards
Height ��l/�"'�R. f�iLC �3 . �� 7� 7�i tle��
/'
Conditions of Approval �
Compliance with P.C. or � �� � �`� ���� ���'
BZA Conditions of Approval y s�� Q`� �N�/� � � 7/f���f
Signage Standards � �
Drainage Plan '�/N�'p ��/�/�f Q, vI� ,
' _ "'/lr_T�/G E./N GcJ� W/,dc �� �d��//�l�✓
REVIEW AUTHORITY
As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval all plans, except the following: (1) Alterations or interior work when the use is
conforming and when no change in use is proposed. (2) Maintenance items, e.g. siding, windows, etc.,
when the use is conforming and when no change is proposed.
�APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
- _ G `
REVIEWED BY: �� � -- DATE: 7�
�'
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"'�^�"'� "" JUN-07—'9� WED 14:02 ID:DILHR: SHAWRNO S & B TEL N0:715-524-3633 �689 P01 —
Wisconsin Depanme�t of Industry, �ERMISSION TO START CONSTRUG...ON Safety and Buildings Division
, Labo�and HumAn R�letions
. NOTE: This permission is applicable only t0 projocts
_ • having below grade foundation work.
Addklonal fees are required. Contact vne of the locations listed below for more information.
Tho informac;on you p►ovido msy be used by othe�government sgency proq�ams�Prlrecr Law,s.t4.04(1)(m)L
•NAIIWARD OFFICE LA CROSSE OFfICE MADISON OFPKE SMAwANO O�FICE WAUKESMA OFFICE
209 W.1 st Sereet 2226 Rose Street 20�E Washington Ave 1340 E.Green 8ar Street 401 Pilot Court
M.8,Bor 9072 La Grosse.WI 5a6p3 PO.Box 7969 Shawano,w1 Sat66 Waukesha.w153188
Hapward,Vvl 54843 rele: (608))85-9334 Mad�son,Wl 53707 Tele: (�15)524-3626 Tele: (4t4)Sa8-8600
7ele: (715)634-4870 FAX: (608)785•9330 Tele: (608)266•9735 FAX: p?S)524-3633 FAX: (414)548-8614
FAX: (71 S)631-51 SO FAx: (608)267•9566
Streei: �2'rj /V, ��f�/ ' E-File:
Clty: ���Q� Plan Number: ���`�q� X,�j
County: _��/�'����r/' Date Plans Rec'd: � — ��q�
Occupa�cy: �
We,the undersigned,raquest to begin foot' g and foundation work prior to approvel of the plans in atcordance with
ILHR 50.14.
We undentand that no detailed review,other than for compliance with ILHR 50.12 or 50.13,will be conducted,by the
Department at this time.
We hav r �e specific code requirements for the building or structure and its use,as set forth in ILHR 50-64,and,
wher , ave shown compliante on the drawinqs.
We agr�p�k�chanyes required after the ptans have been reviewed and to remove or replace non-code
tompl� par�s of the foundation and/or footings.
WQ ��the footings And foundatlon only and will not continue with the remainder of the building or
str��n il� app�oval has been retelved.
We understand that,prior to the start of construction,a 8uilding Permit must be obtained from the local authorities
heving jurisdlctlon fn accordance with their laws and ordinances.
We understand that if this projett is in an unsewered area,a sanitary perrnit must be obtained prior to the issuance of
a local buildinq permit(ss 101.12(3)(h)).
We unde�stand that ii this project wil)disturb 5 or mo�e acres of fand,an Erosion[ontrol N ce f Intent per ILHR 50.11 S
shall be filed wlth the D rtment.
Owner's Signeture: Designer's Signature:
(Orig I S�q at re in n�ina S gn re in In
Date Signed: ,s � Date Signed: f�?��K
Owne�s Name: Designer's Name; �� �. �
Street• �_�,(C/G/l� �Pp, Street:,¢�d+j /� ���M�j(/� ��_
City:���/ /�,��/ State:�`Zip:�� City:���t���_State:�_2ip:��
"'_'7� �
DepaRment Action: �I1p�roved p Not Approved
Review Comme -
!�'��
/ `r'P_ ��5��l��
�,� ��l� �'�",O ('o,
Reviewed By Today's Date
� :
S6D8-198(R.11/94)
FILE COPY
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GENERAL CONTRACTOR
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MASOI� CONTFA�'Z`O� ZONE � D
Widt� of lot_ DATE ZNSP�CTIONS
• — REMARKS
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' ' CODE ENFORCEMENT DIVISION
DEPART�ENTOF COMMUNI?Y DEVELOPME�T
CITY OF OSHKQSH , WISCONSIN
� /D��
VIOLATION / CORRECTION NOTICE �
DATE INSPEC?ED y/�/ �'
--��-
OCCUPANCY INSPECTED � �O �D^S ,l��•—
ADDRESS �'ZS _�// Gl���,�'l�ur�
OWNERS NAME /Lf:`��r- �,,�� h-��-r`.� p�
ADDRESS
NOTI�E DELIVERED/EXPLAINED T0: ,1p �, �` 4 �� �
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c c: __ ��1� )`�«- L�9� S�'��/S
I?EM # ORDER FINDLNGS OF INSPEC?ION
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DEFICIENCI�S MUST �F CORR�CTED AND APPROVED BEFORE
CONCEALMEN"' . ^��L:. ��+.i4) 236-5050 FOR INSPECTION.
COMPLIANCE DATE: �r..� r.oQ� INSPECTOR: � �
• � CODE ENFORCEMENT DIVISION
DEPART�ENT OF COMMUNI?Y DEVELOPME�?
CITY OF OSHKQSH , WISCONSIN
VIOLATION / CORRECTION NOTICE � ���Z
�
DATE INSPECTED 'rJ' !/ r,S :
OCCUPANCY INSPEC?ED �,�s-'�.S
ADDRESS ?,S-" /�/� `i s1
OWNERS NAME /�/r'��P_r— �r�l�erb�i`s �.r
ADDRESS
NOTICE DELIVERED/EXPLAINED T0:
cc:
I?EM � ORDER FINDINGS OF INSPEC?ION
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DEFICIENCI�S MuST aF CORR�CTED AND APPROVED BEFORE
CONCEAL�IEN' . ^��L:., l 41�+� 236-5050 FOR INSPECTION.
COMPLIANCE DATE: �w��,n,��.�'�� I*JSPECTOR: ` yL. oti.l�,E>
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r '\� SAFETY&BUILDINGS DIVI5ION
201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
,7une 15, 1995 _ i.s4i, F,�t r;r�n Ca.y :�t.r�t
�.�� ` -� �� SUITE 's00
r e~ ' �� �?111�W�nQ WI 54166
�S 9��.� ��,_
;}tt`��t'� �irr�i r�.,R� .ti
n,��1�fi,N t " �"' _
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. �JNSC)LIDA'II� t�ONS'IRCI�i'ION MII,I,E�2 IIVIFRPRISES
DRI,E NEL�FN �7E�S MILT�2
4300 N RI(�'.)[�ID S"!'FF�I' 6U6 LIN4E KIIN ROAL�
�� WI 54915 Gxmv �Y wz 54302
RE: I1VI.�70R VQrz�'YRAT.T.
MILLER FI�TIERPRIS�+
'Ii� BAR
825 N wASHPt]Rtv AVE
c�CCxSH r�,c�unty of WII+I�BAc''o
Plan Ntunber 95-06-t�938-P
Ar�a.: 15,858 square fe�r_
S�zprv. Profeasicmal, Huilding: DALE 1VEC.SIIV
Your Pui lding addi t ic�ti pl ans have k.x�,n REILTRt� w i�:.h no act ion
�aken, for �rrectic�ns an�i r�visic�ns.
The plan.s will re�quire revisicx� anr� crorre�ticros r�lativp to �hP c�d� x�ecti�
e i ter_1 k�e 1 cxa bef�rP departm�_n�a 1 cand i t i cma 1 approva 1 r_an b� grantexl.
On� c�py c�f the submittec3 plans has b�*n rPtain�3 for c�ur fil�, �n�i th�
laalance of the plans have k�e�n r�turn�ci to th� d�igner fc�r t;he nec�sary
rwisicros and r�urxnittal.
Follawing revision, p1Q.as� Guhmit at least fo�ir cc�mplete �ts of the pl�,
prop�rly h�and, to the c�epartment f�r re-r�view.
Failure to �how cic�rrectic�ns t� the itPms list� h�lc�w, cm the revise�ci plans,
may r�ult in a de�p�rtm�ntal �ctic�n c�f Nt7T APP�)VID for the rPv�sed plans.
If the revised plans ar� rec.eiv�l by the c�epartment within 6o days nf thP date
�f this let�pr, no additional fees will be require�l. If re.ceive.cl after 60
days, but within 1 year, nf the date of this letter, a fee c�f $'lOt�.00 will kx�
ch�rg�d. Pl an.s r�A i ver� m�re than 'I ye�r af t�r the c�atP of' t.h i s 1�tter must
be acc�mpanied by a Plan A�roval Application Form (SPD11£�) and full fe�s.
��
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�(/�`45
SNUA-69'ltl(It.1U/841 �
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' �
� � SAFETY&BUILDINGS DIVISION
201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
t�:�?LIDATF� c��E��"T'E?t.7c';'IC.�V
Jun� 15, 1995
Pagp► 2
It is strongly reca�nenc�ed that you cx�ntact the r�viewing office, as shown cx►
this letterh�ad, ta s�h�xlu].A a r�-r�view c�f the plar�.s. Fai l�.tre to cal l wi 11 '
result in additional delays in �btaining c.anditional ap�r�v�l.
Tn i n.._4ure pr�r pr�ss i ng of your r�akxn i t�ed p I ans, p 1 eas+� �1 cx� a ccapy
af this letter with yc�ur r��unbittal packet.
II� 52.012 (3)(a} and {b) The �torage rc�a� shc_x�m are n4t s�abd i v i c_i�cl i nto
100 square fcx�t areas k7y f ire-reQi�tive rnnstn_ict ion having a minir�nam
�0-minute rating arnd dc_x3rw�ys pmtectAd k�y at 2e�st 24-min��te fir� c_lcx�r
As.semhl ies. `Ifi i s rec�.a i r� the,�n to have aut�t ic spr inkler pr�t�ct icx�. An
a 1 tern�t iv� wr.�a 1 c� he to is41 at� th� staraqe ax�� into rcxxn� n�� �xc�edi ng
1,5t)0 square feet with at le,.�t 1-hour fire-r�istive con.struction, a
minimwn 3/4-h�ur prc�t�i:icm �f op�nirigs, anc� a prcrperly wir� c��tec�tion
and al�rm fiy:st�m.
II� 55,11 Ex i t 1 ights are requ i r�cl ta ci i rec-t c�,�pants to the ex i t� [s�e
II.fiR 51 ,15 (5}j .
Inclucl� �ir�tic�nal �:xit light!� as ne�ces.sary to direct th�
c_xx�,tpants tc� th� «�xits.
II�iR 55.29 (1 ) {b) A.s rate�d furnac� raam enclosures ar� not shc�rn, th�
�wn�r is to k� r�nind�l �hat heating equipment anc_i water he�t�rs mtLst k�
e 1 ect r i c or d i rec�t vAnt sea 1 ecl comY.�.Lst i on rham�r app 1 i ances.
ILHR 69.19 ADAAG 4.3 The a_.m_�ssik�le rcxitP frc�m �.c_x,�.sible p�rking spac� �
�c�c�sible entr�nr_.ec �hall me�t the r�quir�nents af this r_-cxi� ssrtic_�n, A min.
�f (4) accessihle parking s�ce�s are re.quir�d and shall me�� ADAAG 4,h.
II�iR 69."!9 ADAAG 4.8.4 � lar�ding, at least 5' in 1P..ngth, shall kx� prcyvided at
�c_�u�h Px i� dcx�r. H�ra i 1� �ha 11 k� pr�v i ded at north �x i t doc�r af n�w
ac�,ditic�n, Hanc_irails shall be provic_iecl cx1 kx�th siciee of r�np �� viewing Are.a..
Plea.se submit stair details.
IL�IR 51 .14 sl i�iing glas� dc�or� fihal l k�e safety glaz�ci as sp�ci f i�l in this
rcxie sect i c�.
II� 51 .15(�) (h) A 11 ex i t r�oar� shal 1 b� equippFxl wi th panir hardwar� a�
spec i f i� i n suhr.�.s. 1 . to 3, of th i s code s�ct i cm.
SNUA-fi8'lii lR.lU/94) �
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� � � SAFETY&BUILDINGS DIVISION
201 E.Washingt,on Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
Cx�[wSnLIDA'I'� rx',�'I�?i_7r'I'I!�ti
Jt.ar�e 15, 1995
Pag� 3
This building is classified as t9c�. 6, metal frame construrti�.
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Do�nalc� L. Diedrick
Plan Examiner
(715) 524-3629
DLD:v�s:085�
cc: �tate Building In.��p�ctor: R-3 C�chs (414) 929-3167 Frir�ays
Bui lding Inspectc�r, �J�SHICCXSH
sau�-ee�aa ix.iwsai
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� � SAFETY&BUILDINGS DIVISION
? 201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
Jun� 2 i , i�95 i.i��i �.asr �ree�n �say Str�t
�\+. , . SUI'IE 300
. `- ,. Sl��awano wI 5416G
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C�LIDATE� (S�STRUCTION MILI�R II�I'EFPRISES
DAI� I�.SIIV - .TES.S MIIJ�
4300 N RI�ND SI'RF�'I' 646 LINfE KIIN ROAD
w� wz 54915 c�.ffiv �Y w1 54302
RE: IND�R VUT TF:VRAT.T.
MILL,ER ENPERPRI�
'I'f� H�A�R
825 N W1��l�J AVE
�SHIt�Fi �'�xmty af WI�
Plan Number 95-Ob-093$-P
Area: 15,858 s�quare f�t
Suprv, Prof�ssicmal, L�ui lding: DALE i�LSav
Your Huilr�ing �nci N1�taI Huilding a�cliticm plans hav� been ccxxiiti�ally
approved,
The ataav�e-referenc.�ed plana have k�een �tampe�d CX]NDITIONAI�,Y APPHC�VE� ba,._�'1 ��pon
review for c*rmfQrmar� t� the currwnt �xlitic�n c�f the Wisr�n.sin Administrative
Building az�d Heating, Ventilating Arxl Air c'.on�itic_ming ��cle, chapters
ILHEt 50-f4, b6 & b9. Th� plans h�ve NOT been r�view� for c�c_�formanr_.P tc� the
Plumk�ing Cc�r_le {ch�. II�IR 8�-f36), the El�triral t'1od� (r_h. IIHR 16) ancl any
I II�2 c_�cxi� not spec�i f i�m 11 y m�nt i cm�d.
S�_ilajert to lc�cal regulaticans, rc�nstructic�n may prcxeed Pxcept for thase
conci i t i c�s 1 i st Gci be 1 c�w. � n��.ry c�rr�ct i c�n.s must L� made l�►f ore
rori.st rur_.t i on beq i ns, The c_�x�mer, as def i ne�l i n c-hapter �0'I .01 !2 j(e) ,
Wisrnnsin Statu�es, is r�pon.sible far ccxrtpli�.nce with �11 rode re��irement�,
ThP c�mer s,hall natify th� stat� k�uilding inspe�-tar an�l local c�ffiri�l� txaf�re
taking Po�ssiQn of the bui lding. The }nai lding wi 11 be insspectec] during ancl
af ter c�n.st.ruct icm.
ILHR 50.15 EVID�X�: cJF APPROVAL. Th� arrhitpct, prof�.sicmal �ngineer,
designer, builder �r c�m�r �h8.I1 keep ane �t �f plans bearing the
agprapriate �tamp af apprc�val at the buil�iing site.
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SUUA-88'lif lR.1U/94)
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'\� SAFETY&BUILDINGS DIVISION
201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Kelations
rxl[�[)LIDATE� �S`I�?C1G'1'lr7i�i
,7une 21, 1995
Pa� 2
All futi.ire plan suk�mittals required tc� complete t.his proj�t mt�t bc� �.tk�mittecl
in qu�c.�xuplirate, and h� ac�rompanied hy the Plans Approval Appli�aticm farm
(^E►-11$) and fe�.s. Wh�n thE► b�.ti lcl i ng vc�l�une €�atce�L. 50,QOG rub ic f�t, al l
app 1 i cat i an f orms sha 11 i r�1 ude the name of th� kx,�i 1�i ng or _r.c�npcmP.nt
d�igner AND PE SIG'[� SY 'Tf� S'i7PERVISINC: �SICJNAL nP' 'THE PI�TF�T.
T`his revi ew cic�es n�t i nc l ude l�at i ng, ve�t i l at i ng or a i r c.crnnd i t ic�n ing.
The c_�m�r �hcxz 1 d lae rear�i ricler_i that HVAC p 1� anc� ca 1 cu 1 at i ons are
r�airect to h� s�.il?mitte.d fc�r reviexa and appr�val prior to ins�t�llatic�n.
This kn.�ilding i:s clas�ified as Na, 6, metal fr�me ccx�.struction.
8� .. rely,
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Plan Examiner
(715} 52�-3b29
DI�:vs:1315
cx: �tat� �iilding In.spe�ctor: R-� t�c�hs {414) 929-3167 F'ridays
&zi lding Inspertc�r, c�IIctJ�H
suue-sew�x.iu��
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SAFETY&BUILDINGS DIVISION
201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
,�,�s u't. � '' i�, . ,.. , „ `, : , .
_. � � �, ,.,9. � � � . < ��4u .���st ���:� �ay 5treet
8p��• � � �t '�' �°°'� SUITE 300
Shawano WI 54166
AUG 2 3 1995
TEMPERATURE SYSTE�S ���pp�rM�NT OF MILLER ENTERPRISES
DALE O'CONNELL ��rY^��j'�N�Tf 1�fV�`_��p�`'��jT
JESS MILLER
2200 S ASHLAN� AVE 606 LIME KILN ROAD
GREEN BAY WI 54304 GREEN BAY WI 54302
RE: INDOOR VOLLEYBALL
MILLER ENTERPRISES
THE BAR
825 N WASHBURN AVE
OSHKOSH County of WINNEBAGO
Plan Number 95-06-0938-B
Area: i5,858 square feet
Suprv. Professional , HVAC: DALE 0'CONNELL
Your HVAC alt�'addn plans have been conditionally approved.
The above-referenced plans have been stamped CONDITIONALLY APPROVEQ based upon
review for conformance to the current edition of the Wisconsin Administrative
Building and Heating, Ventilating and Air Conditioning Code, chapters
ILHR 50-64, 66 & 69. These plans have NQT been reviewed far conformance to the
Plumbing Code (chs. ILHR 81-8f}, the Electrical Code (ch. ILHR 16) and anyr
ILHR cade not specifically mentioned.
Subject to local regulations, constructlon may proceed excep� for those
conditions listed below. The riecessary corrections must be made before
c�nstructiun begins. Tt�+e owner, as defined in cha�ter 101 .01 (2)(e),
Wisconsin Statutes, is responsible for compliance with all code requirements.
-- The owner shall r�otify the state building in�pector and locai afficials beforQ
taking possession of the buitding. The building will be inspected during and
after construction.
ILHR 50.15 -EVIDENCE OF APPROVAL. The architect, professional engineer,
designer, bu�lder or owner shall keep ane set of plans bearing the
appropriate stamp of approval at the building site<
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SNUA-68'ltl lR.I W84)
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SAFETY&BUILDINGS DIVISION
' 201 E.Washington Avenue
' P.O.Box 7969
Madison,Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
_�E.MIF�ER��'U�Z� SY�:-'�f�5 i!V'.,
I August 22, 1995
Page 2
All future plan submittals required tfl complete this project must be submitted
in quadruplicate, and be accompanied by the Plans Approval Application form
(SB-i18) ar.d fees. When the building volume exceeds 50,000 cubic feet, all
- applicatfon forms sha11 -in��ude the name of. tbe-.hu.�.l_d-1ng or component . --
designer AND BE SIGNED BY THE SUPERVISING RROFE5Si0WAl OF THE PROJECT.
This building is classified as No. 6, metal frame construction.
Sincerely,
�� . �-`+�`�
Steve P. Daaratz
Plan Examiner
(715) 526-9019
'SPD:vs:0925 �;`
cc: S�zCte Building Inspector: R-3 Ochs (414) 929-3167 Fridays
; c�uilding Inspector, OSHKOSH
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. , Compliance Statement
This form is required to be submitted by the architect,engineer,or HVAC desi�ner(supervising professional)
observing construction of projects within buildings with total volumes exceeding 50,000 cubic feet and construction
of antennas,towers and bleachers(ILHR 50.10). Failure to submit this form may result in penalties as specified in
ILHR 50.26 and/or local ordinances.
General Instructions: Priorto the initial occupancy of new buildings or additions and the final
occupancy of altered existing buildings,submit this completed andsigned form to:
The municipal building inspection office and also to
DILHR,Safety and Buildings,P.O. Box 7969,Madison,WI 53707
Personally identifiable information may be used for other purposes.
1. PROJECT INFORMATION: (Use the DILHR or municipal project label,or type or print the information.)
Owner Information Project Information
Name Bui ding Occupancy Chapter s &Use
_...
� U�- �! o�.�►, �3+���..
A Company Name Tenant Name (i any)
B 1 L = -- — �
um er an treet Bu� ing Locati n num er&street
E . - - • - -��•
� c�
_ _. �City ❑Village ❑Town of�S ,�
H State and Zip Code County o -�
E � "3- !sv� � � v
P an or Re erence Num er Property I enti ication Num er
R - - - 6
E Name an Registration Num er o the Building Supervising Pro essional Building Projed#
Name a d Registratio�Number o the HVAC Supervising Pro essional HVAC Projed#
O. �. t�` C���...,.��. [7�3� 1-� 1 � (03
2. PURPOSE OF THIS STATEMENT: (Check Box A B,or C to indicate purpose and complete any other applicable
boxes and in�ormation. Attach additional pages if necessary.)
❑ Building and HVAC ❑ Building Only r HVACOnIy
❑ Partial Completion
Description of Portion Completed
A) � Statement of Substantial Compliance
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 specifications.
❑ BUILDING ITEMS � HVAC ITEMS
1. Structural system including submittal and erection of all 1. HVAC system including final test
building components(trusses,precast,metal building,etc.) (ILHR 64.53)
2. Fire protection systems(sprinklers,alarms,smoke detectors)
designed and installed by appropriately registered professionals
3. Exits including exit and directional lights 2. All conditions of HVAC plan approval
4. Shaft and stairvvay enclosures and applicable variances
5. Fire-resistive construction,enclosure of hazards,fire walls,
labeled doors,class of construction
6. Sanitation system(toilets,sinks,drinking facilities)
7. ILHR barrier free requirements
8. 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 Date Withdrawn
(Use A or B above to indicate project status as of this date.)
D) ❑ Abandoned
3. SIGNATURES:
�� ''-
Building Supervising Professional Date Profe ' �ate
SBD-9720(R.O1/94)
CITY HALL
215 Church Avenue
P O, Bax 1130
Oshkosh. Wisconsin
54902-1130 City of Oshkosh
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�.�KQ�H Approved: August l, 1997
. ONTHEWATER Issued: March 24 , 1998
MILLER INVESTMEN7S INC
THE BAR
825 N WASHBURN ST
OSHKOSH WI 54904
CERTIFICATE OF OCCUPANCY
An Occupancy Permit is hereby granted for the addition of 4 indoor
volleyball courts located at 825 N. Washburn Street, Oshkosh, WI
54904 as described in Building Permit Application number (s) 45334 .
This space is only to be used for volley ball courts and is located
in the C-2 General Commercial District .
LIMITATIONS :
Maximum floor loading: Per State Approved Plans
Maximum number of persons : Per State Approved Plans
NOTE :
A new Certificate of Occupancy shall be required prior to
occupancy, should additional building (s) be erected, or should any
buildings mentioned above be altered or moved. The use of land or
buildings shall not be changed until a Certificate of Occupancy is
issued for that occupancy.
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DIRECT O INSPECTION S RVICES
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