HomeMy WebLinkAbout0001817-Electric (service change)
ELECtRICAL INSPECTION DIVISION - City of Oshkosh
PERMIT
-6
......
I Lot I Block I Addition I Ward I Date? .-jS-- 7 f/ I
CITY ELECTRICAL INSPECTOR
PERMIT TO DO ELECTRICAL WORK
N?
1817
Permit to install wir d
/7 /7. " es an apparatus as listed herewith in the .
~ " C2. . preInlSes of
..... .. ...... .~~............".....~...........................~~ Occupied a&~ ~ rz."." " . .
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.................. ............................................................................ Floor........................................ Boom................................................
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¡ New ¡RePlace. ! I i New Replace.' New 'Replace. I '- New Re~lac"
ment I . ,men' ment mant
Fixtures ! Fan or Blower Outdoor Sign
Switches Unit Heaters Indoor Sign
Receptacles Furnace or Boiler Service Ý ~/Që) ItVo "'¡ /1Jh~. ( '"...... L (p~
~
Circnits Air Conditioner t~ -
Range
Garbage Disposal I Water Heater Electric Heating'
Dish Washer Dryer
Horse power
Motors of each
Transformers Capacity
of each
. -- .. ..
~
Temporary Work
¡Description
I Date
Valuation of Work Described Herein Permit and Inspection Fee Received Remarks \ No. of Inspections and Dates
$,/.5:0..~ NJG 15 1978 lkI
Date ........................ Amount .:3'..... """ I Final Inspection ...................,........ ...................
This permit authorizes only work applied for herein, Other work must be covered by additional permits.
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ecif.J*tor ....~.:,~.. ,...~ ........... .......... -,
...........,..,...................... .....
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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)
~ {f ;1(71-' . I rib 0 ,0/:.4:0/ ~ø ~ /
Name 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 resldence) which is owned and occupied
by him, or is being constructßd 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. .
. Dato' th1' 15M 0/', ~:'lf.
Subscribed and sworn to before '
this --15.J1. day of -D l~r/.jJj ,19.2f..
'i)n/Vù(J!/ l p,j¡mAd
Notary Public, Winnebago County, Wisconsin
MY COMM'SSION~j(~\~~s
My Commission Expires: JULY 20, 198!
ADDRESS I 'X,')u £k ~ Q &v\ ð ~ Q'<¡ ^^'- -'- -
OLD ADDRESS
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