HomeMy WebLinkAbout0000144- Electric (fixtures) ELECTRIC.irL INSPECTION DIVISION — City of Oshkosh PERMIT
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N° 14 4
e• PERMIT TO DO ELECTRICAL WORK
ILot I Block Addition I Ward Date 12-9-76
CITY ELECTRICAL INSPECTOR
Permit to install wires and apparatus as listed herewith in the premises of
• C. J. Beck owner Single Family Residence
Renter Occupied as
Number 9 2 0 Street No. Lark Floor Room
Owner
Contractor Address
i New Replace- I I New Replace- New IReplace- I New Replace-
s ment I ment ment ment
Fixtures 1 Fan or Blower I Outdoor Sign
I
Switches 1 IIIIIIIIIEIIMIIMMIIII Indoor Sign
Receptacles 2 -■I Furnace or Boiler Service
Circuits ■-■I Range Air Conditioner
Garbage Disposal I 1111EMIll
Dish Washer ■-■I Dryer I Underground o Garage
Horse power
Motors 11111 all of each
Capacity
Transformers of each
Void after
Temporary Work ,Description Date
Valuation of Work Described Herein Permit and Inspection Fee Received Remarks No. of Inspections and Dates
•
4.:,7.. c 197G
K 0 . 0 0 �-` 1.0 0
$� Date Amount Final Inspection
This permit authorizes only work applied for herein. Other work must be covered by additional permits.
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Master Elee 'cian or other Authorized Person Electrical spector
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AFFIDAVIT RELATING TO SECTION 13.12 (c ) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
SS
WINNEBAGO COUNTY )
( -me (Address )
first being duly sworn on oath, deposes and says that he is not
a licensed electrician in the City of Oshkosh and that he has
applied for an electrical permit to do electrical work in a
residence and/or auxiliary buildings (intended solely for pur-
poses associated with a residence ) which is owned and occupied
by him, or is being constructed in his name , as his personal
home and that said residence or auxiliary buildings being so
wired are not to be used or erected for rental purposes or for
resale to present or prospective purchasers.
Affiant understands that the electrical work authorized by
the permit applied for in connection with this affidavit , must
be done only by this affiant and that he cannot employ others to
assist with the electrical work but members of his immediate
family.
(
Dated this � day of �,p� , 19 ,
C� 5`.l
Subscribed and sworn to before '-'
s •f41,-4140„ , 192Z.
. & 4,11c611
y Pub - , Winnebago County, Wisconsin
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