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HomeMy WebLinkAbout0099539 EOSHKOSH ON THE WATER Job Address Contractor Service Volts Amps 713 N SAWYER ST HOMEOWNER [~ New (~) Change (~) Tamp CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner Category No 99539 JEFFERY E NICOLAISON/K L DERR Create Date 01/22/2003 612 - Residential-Single Family Addition/Ret Plan Type I© Overhead (~) Underground I Circuits 0 Fixtures 0 Switches 0 Receptacles 0 Appliances Use/Nature of 1/22/03 permit for garage wiring Work Fees: Valuation Issued By: $800.00 Plan Approval $0.00 Permit Fee Paid $25.00 Date 1/22/03 Permit Voided 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 work I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address OSHKOSH WI 5490 - 3358 Telephone Number OSHKOSH ON THE WATER CITY OF OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD Job Address 713 N SAWYER ST Contractor HOMEOWNER Service ~ New (~ Change (~ Tamp Volts Amps 0 No 99539 Owner JEFFERY E NICOLAISON/K L DERR Category 612 - Residential-Single Family Addition/R I Type Circuits 0 Switches 0 Overhead Create Date 01/22/2003 Plan (~) Underground Fixtures Receptacles Appliances Use/Nature of 1/22/03 permit for garage wiring Work Fees: Valuation Issued By: $600.00 Plan Approval $0.00 Permit Fee Paid $25.00 Date 1/22/03 [] Permit Voided 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 work I agree to perform all work pursuant to rules governing the described construction. Signature ~ ~ ~ ~ ~ , ~ . ~r.~ (~ ~ Agent/Owner Address OSHKOSH WI 5490- 3358 Telephone Number Date