HomeMy WebLinkAbout0099550-Electric (service change)OSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Job Address 1119 FILLMORE AVE
Contractor HOMEOWNER
Service ]~ New (~) Change (~) Tamp
Volts 220
Amps 200
Owner
Category
Circuits
Switches
No 99550
MORTON M/LISA A NEWCOMB
634 - Residential-Service Change
Type (~ Overhead
Create Date 01/22/2003
Plan
(~ Underground
Fixtures
ReCeptacles
Appliances
Use/Nature of 1/22/03 service change to 200 amps
Work
Fees: Valuation
Issued By:
$1,000.00
Plan Approval
$0.00 Permit Fee Paid
[] Permit VoidedI
$45.00
Date
1122/03
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 p~.erform all work pursuant to rules governing the described construction.
signature 3~' !~,~,¥,,.~ ~%~"X ~ ~...~'~ ' Date
Agent/Owner
Address OSHKOSH WI 5490- 3409 Telephone Number