HomeMy WebLinkAbout0025278-Electric (sunroom)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
25278
TYPE: BLDG 0 HTG 0 ELEC ~ PLBG 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
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ADDRESS l1 0 ~ /I 1+ ~ _
OWNER D~ of- ~~
PLAN NO.
DESIGNER
USE/NATURE OF WORK
v>V'\~ ~ ~
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.,
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR & bf/x.//l..-
Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_
Fixtures K Switches tx..., Receptacles /^......~ Circuits L\-
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PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
ISSUED BY
I
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Permit- Fee Paid $ . S-
Date? -/~-r/
,
Park Dedication $
Final/O.P.
SIGNATURE
~rto'm all wmk pu",uan' '0 m'es 90vemln9 'he dese"bed co,"'mction.
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rI~GENT/OWn c9~s_D;;/71
7 TELEPHONE #1
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ADDRESS
PERMIT NO. ')..)"2721' .APPL. DATE ~-I?J-7/
ELEC. CONTR. ~ .
/J~ 03~
I ,?t;J~-, ~~/
OWNER
ADDRESS
NATURE OF WORK
ELEC. SERVo NEW
DESC. TYPE
FI X ' S 1><..... SW I S
APPLIANCES
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CHANGE
VOLTS
RECEPT'S
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TEMP.
AMPS
CIRC'S
S I'GN S
INSP. ROUGHIN
EST. COST
REMARKS
SERVICE FINAL
15 (? ~ PERMIT FEE 1'5"~"" -DATE PD ..9'..../?J..-7I
AFFIDAVIT RELATING TO SECTION 13.12 (c) OF A GENERAL ORDINANCE
OF TEE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
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~f10 \:Y' ~.pr~\V;)
(Name )
,
\ '1"'.s tJ I Co \L,oQ. Y L.j
, (Address)
f1rst be1ng duly sworn on oath, deposes and says that he 1s not
a 11censed electr1c1an 1n the C1ty of Oshkosh and that he has
applied for an electrical perm1t to do electr1cal work in a
residence and/or auxil1ary buildings (intended solely for pur-
poses associated w1th a residence) which is owned and occup1ed
by h1m, or 1s be1ng constructed in his name, as his perso~l
home and that sa1d 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 app11ed for 1n connect1on witb this aff1dav1t, must
be done only by th1s atf1ant and that he ca~not employ others to
ass1st with the electr1cal work but members of h1s 1mmediate
family. .
Dated this / 0
, 19 1/.
t>
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Subscribed and sworn to before
t~;~X~ · 19~.
Notary utilic, W1nnebago County, Wiscons1n
M;r Commission Expires: T~ 7- /9'1~
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