Oshkosh Pacur Permit — Ron Johnson 201402286 (2014)

OSHKOSH ON THE WATER CITY OF OSHKOSH PERMIT Permit # 201402286 Issued Date 09/24/2014 Job Address 3555 MOSER ST Owner RONALD H/JANE K JOHNSON LLC Parcel ID 1519606400 Category Business/Office Contractor CR MEYER Use Commercial Business Pacur Description Office remodel - to include new bathroom layouts and adding offices Permit Details Sqr Foot 2,190 Occupancy Permit Alarm Submittal Alteration Level 2 Floor Levels 1-Story Alarm Type Building Plan YES # Structures Alarm Monitoring HVAC Plan YES # Units Fire Suppression Occupancy Fire Sprinkler Construction II-B Sprinkler Design Fees Issued By John Zarate Valuation $0.00 Fees Building Review $250.00 HVAC Review $150.00 Building Review $100.00 Building Permit $395.20 Property Record $131.40 $1,026.60 Payment [illegible] Conditions In the performance of this work 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 contract the easement holder(s) and to secure any necessary approvals before starting such activity. I have read and understood the aforementioned information. Signature [Signature] Signed By: Pete LeCompte Date: Wed Sep 24 2014 07:45:22 Date 09/24/2014 Agent/Owner Address [illegible] To schedule inspections please call the Inspection Request line at 920-236-5128 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.

CR MEYER 895 W 20th Avenue, PO Box 2157 Oshkosh WI 54903-2157 Phone 920.235.3350 Fax 920.235.3419 To: City of Oshkosh 215 Church St., PO Box 1130 Oshkosh, WI 54902-1130 Attn: John Zarate Date: 10.21.2014 Our Job No. Your Job No. Regarding - Project Pacur- Office Remodeling Project Location 3555 Moser St. Oshkosh, WI GENTLEMEN We are sending you x Herewith Under Separate Cover Plans Prints Shop drawings Specifications x Correspondence 1 Copies Building Compliance Statement Copies Copies From CR Meyer Covering Building Compliance Statement Which are: (as checked below) For Approval For Your Use For Correction X For Files and Distribution For Final Approval For Field Use For Your Use in Preparing Shop Drawings For Sending Us a Quotation by For Fabrication of Your Material Date Time AM PM Please Return Copies to Remarks: Copy of Correspondence Sent to: Tim Miller, CR Meyer Yours very truly, CR MEYER Pete LeCompte

BUILDINGS, 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, 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 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. APP Transaction ID Number 113879 Project Name PACUL OFFICE REMODELING Site Number Site location (number & street) 3555 MOSEN ST. [x] City [ ] Village [ ] Town of OSHKOSH County of WINNEBAGO 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.) CURRENT PLAN Check those which apply: [x] Building Object ID # BS-3555-0714 [ ] HVAC Object ID # [ ] Partial Completion Description of Portion Completed A) [x] 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. [x] BUILDING/LIGHTING ITEMS 1. Structural system including submittal and erection of all building components (trusses, precast, metal building, etc.) 2. Fire protection systems (sprinklers, alarms, smoke detectors) designed, installed, 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 of construction, fire stopped penetrations 6. Sanitation system (toilets, sinks, drinking facilities) 7. Barrier-free including SPS 318 elevators and lifts 8. Energy envelope requirements 9. All conditions of building plan approval and applicable variances 10. Exterior lighting & control requirements 11. Interior lighting & control requirements 12. All conditions of lighting plan approval and applicable variances [ ] HVAC ITEMS 1. HVAC system including final test 2. All conditions of HVAC 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: [x] Building [ ] HVAC PETE LECOMPTE Date 10.21.2014 Name (please print or type) Phone number 920.427.4850 Customer ID # Signature Pete LeCompte SBD-9720 (R.9/14)

PACUR-EGRESS Designer 11/27/2014 10:47:00 AM Plot Scale 1:100 3 of 4 EGRESS ZONE # 1 EGRESS ZONE # 2 Statistics | | | | | | | |---|---|---|---|---|---|---| | | | Avg | Max | Min | Max/Min | Uniformity | | EGRESS ZONE # 1 | + | 14.6 fc | 36.2 fc | 1.2 fc | 30.2:1 | 0.4:1 | | EGRESS ZONE # 2 | + | 13.1 fc | 35.0 fc | 1.3 fc | 26.9:1 | 10.1:1 | 0.4:1 |