HomeMy WebLinkAbout0146995-Building (antennas) CITY OF OSHKOSH No 146995
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 780 HIGH AVE Owner BOARD OF REGENTS UNIV OF WIS SYS Create Date 07/27/2011
Designer Contractor TENANT
Inspector John Zarate
Category 250 - Satellite Dish /Antennas Plan
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning Class of Const: Size
Unfinished /Basement Sq. Ft. Rooms Height Ft. ❑ Projection
Finished /Living Sq. Ft. Bedrooms Stories Canopies
Garage Sq. Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain No Height Permit Not Required
Park Dedication Not Required # Dwelling Units 0 # Structures 0
Use /Nature RELOCATE (1) ANTENNA AND ADD (1) NEW ANTENNA ONTO EXISTING BALLAST FRAME. TOTAL OF (3) RELOCATED
of Work ANTENNAS, (3) NEW ANTENNAS AND (6) ADDITIONAL COAX * *check #10158
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $30,000.00 Plan Approval $0.00 Permit Fee Paid $178.00 Park Dedication $0.00
Issued By: 1,4V- Date 07/27/2011 Final /O.P. 00 /00 /0000
❑ Permit Voided Parcel Id # 0506650000
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.
1 have read and understand the afore mentioned information.
Signature Date
Agent/Owner
Address OSHKOSH WI 54901 - 0000 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 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
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 01HKO.JH
Building Permit Application ON THE WATER
If you are a contractor participating in the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account fl
JOB ADDRESS 780 High Avenue, Oshkosh, WI 54901
OWNER University of Wisconsin - Oshkosh
CONTRACTOR Midwest Tower Erection
I am the: ❑ Owner OR X3 Contractor
USE CATEGORY
❑Single Family ❑Duplex ❑Multi - Family DRental XlCommercial ❑Industrial
Work being done:
❑ Addition ❑ Deck/Porch/Patio ❑ Driveway/Parking
❑ External Remodeling ❑ Fence/Hedge/Kennel ❑ Garage/Utility Structure
❑ Handicap Ramp ❑ Hot Tub/Spa ❑ Internal Remodeling
❑ Sign/Canopy /Awning ❑ Stair/Handrail ❑ Stove/Fireplace
❑ Swimming Pool ❑ Wrecking Permit
Xi other. Telecom Facilities - Rooftop Antenna Relo & Install
For External Remodeling, Wrecking Permit, and Internal Remodeling please see Chapter NR 447 of the Wisconsin Administrative Code and
Notification Form 4500 -113 on the DNR Asbestos Program website; htto: / /dnr.wi.aov /air /comoenf /asbestos/.
For additional information on hazards present in buildings see the Pre•emolition Environmental Checklist at
htto: / /dnr.wi.aov /ora/aw /w rn /publications /anewoubIWA651.odf.
Additional information, such as plan submittal and approval, may be required before issuance. Fliers,
located in the hallway, may be referenced to note if any additional information is necessary.
❖ Full description of work being done: Relocate one (1) antenna and add one (1) new antenna
onto existing ballast frame. Total of three (3) relocated antennas, three (3) new antennas and six (6) additional coax.
Any work not included in this application is not permitted.
Value of the job $ 30,000 (Value for materials and labor is required to ensure consistency in accessing permit fees for all
applicants.)
PLEASE READ, SIGN, & DATE:
I certify the above information is complete and accurate. Any deviations from the above submitted
information may require additional permits to be obtained. 1 acknowledge and agree to these terms.
RECEI Name: �, SG1 1��11,F� � l
VED (Plea ' t> f
JUL 1 4 2011 Signature:
DEPARTMENT OF Date: 7//3/it
COMMUNITY DEVELOPMENT < 3/02
INSPECTION SERVICES DIVISION