HomeMy WebLinkAbout0111711-Building (siding)City of Oshkosh
Division o f lnspectlon Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(prilnt homeowner(s) name)
the homeowner(s) of ~-~l ~c~ ~--~-~ /~t~ ~
(address/vhere work is to be performed)
accept the responsibility for performing the electrical work as stated below for the property listed
above.
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or MC Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable; Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. lVork on a condominium,
duplex, rental, or multi-use building wouM require a licensed master
electrician.
Other
The value of this work is $
I hereby verify this work will be performed by me and further verify the reconnection /
installation will be done in compliance with manufacturer and Electric code requirements.
(Date)
5/02