HomeMy WebLinkAbout0008737-Electric (furnace & a/c)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
08737
~DDRESS
d),
l~P_E~ _ _ ~L~~ _~ _ ~T~ _ ~ _ ~~E? 4 ~~B~ _ ~ _ ~I~~ _~ _ ~O_N~N_G _ _ _ _ _ _ _F~~~D_ ~L~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _
~22~
G~/~
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
, ~
w~ o--u- 0 ~/ '
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
, Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Fixtures
New 0 Change 9>(:m 0 Type_
Switches Receptacles
~U
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
Volts_ Amps_
k
Circuits
%U
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_we _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
;...~
Other
L-~
FEES: Valuation $ /' ,/
ISSUED BY~.
~ /
Permit Fee Paid $ I#- 7
Dated' -(3- 1"7
Park Dedication $
Final/O.P. g - ,~ 5' - ~~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUREc::t1~~~
ADDRESS,5?.2 ;> ~7;;;", U,
Gft~i~O
.z.J-1-- ()tf fiXO
TELEPHONE #
r)
Al"'FIDAVIT B!L.A1'ING TO SECTION 13.12 (c) OF A GENERAL ORDINANCE
OF TRS CITY OF OSBKOSa RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSI~)
. } S5
WINNEB.AGO COUN'l'Y }
llA-rt/7? /1/ :;Ltc~! IV Ell r ,
(Name) . '
22i r ;Uf!lfrtO;./ .II
Add.ress
first being dulY' sworn on oath, deposes and saY's that he is not
a licensed electrician in the C1ty of Oshkosh and that he has
appl'ied fer an electrical permit to do electrical work ina
reSidence and/or aux111ary' bu11dings (intended solelY' for pur-
poses assoc1ated with.a res1dence) wh1ch 1s owned and occup1ed
b1 h1m, or 1s being constructed 1n h1s name, as h1s personal
home and that sa1d res1dence or aux1l1ary bu1ld1ngs being so
wired are not to be used or erected for rental purposes or for
resale to present or prospective purchasers.
Aff1ant understands that the electrical work authorized by
the permit app11edfor 1n connection with th1s.affid.avit, must
be done onlY' by this.affiant and that he cannot employ others to
assist with the electr1cal work but members of h1s 1~ed1ate
fam1ly.
Dated th1s !J
day of t~
o
, 19~
() <J~ ~-::;;J
Subscr1bed and sWorn to before
this c~b %. daY' of ~ , 19.E.[,..
'~~g'4~j~ '
NotarY' Pub11c~. W1nnebago CountY', \<I1soons1n
MY' Commission Expires: QL?1'LQ... ;: /99 P--
I
o~ 1 J 7
PERMIT NO.
E'LEC. CONTR.
,/
OWN~R (2~ ~
ADDRESS ;2~~
~~:v~OR:E~- ./ caEr- - ~~. '.~
DESC. TYPE = VOLTS AMPS'
iI]d\ SW' S '~ REcEPT · S CIRC' S .:::
~PPLIl\NCES -= .:
SIGNS . ~-;).'~
l!"sp"=ROUGIlIN --: SERVI CE FIJlAL~
W':hJ;OST 7 .,~ PERMIT iP'~O '" .-!1l'':!')\;.. m -I.N'!:
REHl'~ .:::=--
--- -
-----
=