HomeMy WebLinkAbout0001855-Electric (kitchen remodel)
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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 )
~ AI aJ.~a.
I' ( Name ) . . /
,
/Y'/P ~ ~.
(Address
first being ~uly sworn on oath, deposes and says that he 1s not
a l10ensed electrioian in toe City of Oshkosh and that he has
applied for an electrical permit to do electr1cal.work in a
re~idenoe and/or auxiliary buildings (intended solely for pur-
poses .assooiated w1 th a res~dence) ... 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 p~rchasers.
Affiant understands that the electrical work authorized by
the permit applied for in connect~on with this a.ffid?ylt, must
be done only by this affiant and tqat he cannot employ others to
assist with the electrical work but members of his immediate
fa.mily. .
Dated this #.
day of P
, 19.d..
~/ ~~~,)
Subscribed and sworn to before
this )? th day of .30 [)1Plmttt/L, 19.2d:
c-f} ~r/ 'i?viJlf/1#
No,ary Pub11c. W n~ebagIL. Coun~.'t, .H,tsconsin
f;JlJY COMM,~'C/, -" u,PifH"S
My Commission Expires: JULY 20, l!iil