HomeMy WebLinkAbout0000635-Electric (service)
ELECT'iUCÂL INSPECTION DIVISION - City of Oshk~sh"~
'J
PERMIT
~'!I?'
I Lot I Block I Addition I Ward I Date 6-9-77 I
CITY ELECTRICAL INSPECTOR
PERMIT TO DO ELECTRICAL WORK
N2
635
)
Permit to install wires and apparatus as Usted herewith in the premises of
Owner
.............:Er..'P..\Ì....Ri.Q-fL........................................................................................Renter'
Occupied as..... Single Family Residenoe
.................................................."....,............................................................
Number........3..9..7............... Street............N.,....l!!::!<.h....AY..'P......................................................,.............................,................... Floor......"................................ Room..............,.................................
Contractor ........Y.l':~~.!..................................................................................................................Address ..................................................................................................."""""""""""""""""""""'"
oj
i New i~~~:-- I I New Replace. ' New Replace. New Replace-
ment ment ment
Fixtures Fan or Blower Outdoor Sign
Swltcbes 2 Unit Heaters Indoor Sign
Receptacles 2 Furnace or Boiler Service X 2/3 tc 3/100 Amp.
Circuits Range Air Conditioner
Garbage Disposal Water Heater Electric Heating'
Dish Washer Dryer
Horse power
Motors of each
Transformers Capacity
of each
Temporary Work Description I ~~~~ ~~~~~........................................................
Valuation 'of Work Described Herein Permit and Inspection Fee Received Remarks No. of Inspections and Dates
$....1t9.9..~.9.9............................................ JUN 9 - 1977 8 00 Final Inspection ............................ ...................
Date ..... ........ Amount ........,... ......
This permit authorizes only work applied for herein. Other work must be covered by additional permits.
Mäs@J~ötii~~ë¡;söÏi""""""""""""""""" .............................
~: ~~1~~
........... '" ...... ....... .........,.... .«......... .
Elcclr cal pector .., . ................ ..................... .. ""
;1
AFFIDAVIT RELATING TO SECTION 13.12 (0) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY)
hÆ:D ~I è£
/ (Name)
..3 ò 7 ;?y; / Y/6:fC
(Address)
first being duly sworn on oath, deposes and says that he is not
a licensed eÌectrioian 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
9-
/
day of
..;;;r¿/vE
, 1977.
GJ¿ /1 L- ÇJ
" "
lr~J!
Subscribed and sworn to before
this -L day of a~"c'/
#-~~ ;7/; rØ::¿fk
, 19.L2.
Notary Public, Winnebago County, Wisconsin
',y C!v,'1',!,S'iON E"HRES
My Commission Expires: " ~ÅÁRëH ~12. 1978