HomeMy WebLinkAbout0099165-Electric (bedroom remodel) SHKOSH
ON THE WATER.
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 1257 ELMWOODAVE
Contractor HOMEOWNER
Service ~) New O Change O Temp
Volts
Amps 0
Owner
Category
Circuits
Switches
No99165
THOMAS D/MARY BURNS
612 - Residential-Single Family Addition/R
Type ~) Overhead
Create Date 12/20/2002
Plan
(~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of 12/20/02 remodle bed room
Work
Fees: Valuation
Issued By:
$200.00 Plan Approval
$0.00 Permit Fee Paid $20.00
[] Permit Voided
Date 12/20/02
The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied
as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other
individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the
City of Oshkosh to perform said work.
In the performance of this~ w~/~gree to perf/o,~ll work pursuant to rules governing the described ~nstruction-
Signature
Agent/Owner
Date / ~ ~'~'~,...-'
Address OSHKOSH WI 5490- 2753 Telephone Number