HomeMy WebLinkAbout0001366-Electrical (fixtures & misc)
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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 )
~-Y;;E gRIVH~/?
(Name )
, /?()O JluPf4i?J;!
, (Address
first being duly sworn on oath, deposes and says that he is not
a 11censed electrician in the City of Oshkosh and that he ha$
applied for an electrical permit to do electr1cal.work in a
re$idence and/or auxiliary buildings (intended solely for pur-
pO$es associated with a res~dence)'which is owned and occupied
by him, or is being construct~d in his name, as h1s personal .
home and that said residence orauxillary 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 cqnnection 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 ~j7
day 0 f "\: -r/+ }./"
, 191J(..
~rt ~~
,
SUbscribed and sworn to before
this rilH~ day of d/JJfUlf!A ~ ,19ft.
'i)a11f1f V.!? ~'1d
No~ary Public, Winnebago County, Wisconsin
MY COMMISSION eXPIRES
My Commisslon Expires: JULY 20, 1981