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HomeMy WebLinkAbout0019864-Electric (service upgrade) ~ PERMIT - APPLICATION A~D RECORD CITY OF OSHKOSH. . . ~. . ~,' N~ 19864 OSHKOSH Address I;::¿ ¿¡r L¡ / ~ j"q: 4?'f. Owner ~ L ~ ~ Id. No. Lot Block - Ward- Subdivision Zoning~ Parkland Dedication Fee Height ~ Flood Piain- Type of Permit: Building D Electrical~ Heatinç¡ n Plumbing D Sign D Wrecking D Fence D Pool D Occupancy Permit Required /y\.¿;~ Insp. :J;2 u'- Permit Date ;) -/ -g 5 Nature of Work BUILDING Use Generai Cont. Foundation Siding Type of Construction PLUMBING CONTRACTOR Bu. San. Sewer ~ Curb to Bu. Bu. St. Sewer Curb to Bu. Size: ~feetwide X feet long Square feet area Main to Curb: Main to Curb Height: Stories and Basement above Grade W;dth ofLot No. of Rooms Sewer Fees Î Mason Water Service Bath Tub Floor Drain Urinal Wash Basin ~ Garbage Disp. - S. Sink Water Closet ~ Dish Washer ~ Catch Basin Kit. Sink Laundry Mach. - S. Pump - Water Heater ~ Water Soft. B & S Waste ~ Shower Bath ~ Bubbler Conductors Plumbing Fees Total Fees Carpenter I ft. I '- Architect '------Ít 1 1 -----Ít -I Inspections - Footing Foundation Eiectric Service HEATING CONTRACTOR Fuel: Gas 0 Oil 0 Elec. 0 Solar 0 Solid 0 Conditioning Forced Air 0 H.W. 0 Elec. Base 0 Steam 0 Radiant 0 System High Eft. 0 Supplementary 0 Air Condo 0 Ventiiation 0 Chimney: "A" 0 "B" 0 Direct Vent 0 Can. Burner 0 Flue Damper & E.I. 0 Calculated Heat Loss System E}JU Rating '-""-A cý Z; Estimated Cost )0/5 :7 ./ v .- Fees Paid TO THE BUILDING INSPECTOR: In accordance with Section 7-18 01 the Municipal Code ofthe City 01 Oshkosh, it is agreed that ilwork shall be discontinued for a period of30 days at anytime for any cause after excavation work is commenced, a solid barrier, wall, orwire lence not less than five feet in height shall be erected all around such excavation. Such barrier, wall or wire fence will remain in position until removal is approved by the Building Inspeclor Sewer R.I. ELECTRIC CONTRACTOR Electric Service: New . Changes ~ Temp. Descriptlån-Type :J. - 30? )- ./éJO '-O6'-volts U~£fC) Am psß2. ° Fixtures Switches Recep's ,- Circ's' Appliances X In the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes, ordinances, codes, and rules governing the described construction. (Signed) 'r fP ~ Owner Address W fir ø I Z2K :p--e Phoneb< j/- 7 t? /' () By (A"tho""d Slgo,,",,) Agent Electricai Signs Address Phone 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) <-M#E1 £ 5~//A(T Name ) If} g- ¿lJ /y!2!' 1/é. (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 residence) which is owned and occupied by him, or is being constructed 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. @1');l. .' 19¿r . " " é#Jef Subscribed and sworn to before t~~f' ~~~ ,,-Sf-- Notary Public, Winnebago County, Wisconsin My Commission Expires: MY CCMW!1SStON EXPIRES JUNE 7,1987 Dated this ~j- ~ 1 PER~1!T NO. ) l' g b 'I APPL. DATE F ~ / ~ g S ELEC. CONTR. ~~~ OWNER y~~ . ~27'-- ADDRESS /2'j{ - ù./~ / If~/ NATURE OF WORK' ELEC. SERVo DESC. TYP FIX'S APPLIANCE:'; NEW ) SW'S -4..,- CHANGE TEMP. VOLTS ;2Q ~ ¥'CI AMPS'/ ð 0 RECEPT'S CIRC'S SIGNS <~: INSP. ROUGHIN EST. COST? ----- REMARKS