HomeMy WebLinkAbout0019762-Electric (service change)
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OSHKOSH
Lot
CITY OF OSHKOSH t
Owner '/11/7)£-1# /Z<J r ~ ' ò'
Zoning- Parkland Dedication Fee Height PermiL
Sign 0 Wrecking 0 Fence 0 Pool 0 Occupancy Permit Required /1y:>j-- Insp. ~
Address
PERMIT - APPLICATION AN~RE.9°RD
?-7 tb ~ u/,.-é( If«.
Block - Ward- Subdivision
Type of Permit:
Building 0
Nature of Work
PLUMBING CONTRACTOR
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
Main to Curb:
Main to Curb
Sewer Fees
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
HEATING CONTRACTOR
Fuel: Gas 0 Oil 0 Elec. 0 Solar 0 Solid 0
Conditioning Forced Air 0 H.W.D Etec. Base 0 Steam 0 Radiant 0
System High Eff. 0 Supplementary 0 Air Condo 0 Ventilation 0
Chimney: "A" 0 "B" 0 Direct Vent 0 Con. Burner 0 Flue Damper & E.!. 0
Calculated Heat Loss System BTU Rating
ELEÇTRIC CONTRACTOR
Electric Service: New Changes
Description-Type À -31Jb ~ -UJ~
Fixtures Switches
Appliances
- Temp.
Volts I ?-7;)...4' 0
Recep's 1><.
Electrical Signs
N~
19762
Id. No.
Flood Plain-
Permit Date t.j. -.).Y-í?5
BUILDING Use
..:1~
General
Siding
Type of Construction
Foundation
Size:
_feet wide X
feet long
Square feet area
Height:
Stories and Basement
above Grade
Width of Lot
No. of Rooms
1
Mason
Carpenter
Architect
1 It.
I
1-
I------It.
l
I
-----It.
Inspections -
Footing Foundation
~ I Electric Service R.!.
~ Sewer Water Service
Q
4
Estimated Cost K¡J (£}O~ Fees Paid VP ¿?'-. T"-- Date
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code of the City of Oshkosh, it is agreed that if work shall be
discontinued for a period of 30 days at anytime for any cause after excavation work is commenced, a solid barrier, wall, or wire fence not less than
five feet in height shall be erected all around such excavation. Such barrier, wallorwire fence will remain in position until removal is approved by the
Building Inspector. 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) f<~,..v '"1/). '1Je~ Owner
Address ;¿:;U, tv ¡I./-t;" AJve.. Phone 4:;U,,-~C}C¡'¡),
By
Agent
(A"'hm;,,' 51",,",,)
Address
Phone
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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)
1<,0.+11 I~Y\ (f). Henke..-
(Name )
If' ) y.,1:J, ¡4Vb:-.
Address
ddb
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.
Dated this
23
day of ¡¡'P,zlL
, 19~-
+(~ /'Y1. ~)ð ~
to before
,19gr
Winnebago C unty, Wisconsin
MX......CÇ¥MISSION EXPIRES JUNE 7,1987
My Commission Expires:
ELEC.
DATE Jf - :23 - ¿? S-
PERMIT NO.
ADDRESS
NATURE OF WORK
;;2;Z6~
_4I~
Uv-¡ <f~~
OWNER
ELEC. SERVo
DESC. TYPE
FIX'S'
APPLU;NCES
SIGNS
INSP. ROUGHIN
EXT. COST 6é1. ~
R];;MARKS
..J.Á/
CHAN E
VOLTS
RECEPT'S
AMPS¿: ()
CIRC'S><:
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