HomeMy WebLinkAbout0004734-Electric (garage)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND -RECORD
04734
ADDRESS
TYPE: . . ~LD~ .0 . HT~ .I? E:EC k~Lf3~. O. SI~N .0 ~ ZO.~NG. . . . . . FL~~D ~~'~. . . . . . ~~'~~. . . _ .
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PLAN NO.
OWNER
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DESIGNER
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USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
, Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Loss
BTU'S
ELECTRIC CONTRACTOR
Electric se;:xrv. New 0 Change Ci..Jemp 0 Type -----.. you. - X
Fixtures ~ Switches - ~ J:leceptacles ~frcuits_
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9Ji) .
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_Disp
_DW
_SP
_ WSoft
_DF
_ CBasin
_ San. Sewer
_Lav
_WC
c
_Sink
Other ____,;
_FDr
_ L Tub
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
Permit Fee Paid $
Date
/
J.rP C V Park Dedication $
7--7 '7_ 5?1'7 C -(7.6 ~-x7
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ISSUED B
SIGNATURE
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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ADDRESS
~31- ~7906
TELEPHONE #
AFFIDAVIt RELATING TO .SECTIO.N 1:;.12 (c) OPAGl$~ O~D+N,ANCE
OF TEE CITY OF OSEXOSHRELATING TO TEE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
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STATE OP WISCONSIN)
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<~t WINNEBAGO COUNTY }
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( Name )
, d3i7 e::;~~f
Address
f1rst be1ng 4~ly sworn on oath, deposes and says that he 1s not
a licensed electrician 1n the C1ty of .Oshkosh and that he has
applied for an electrical permit to do electr1cal work 1n a
res1denceandlor auxil1ary build1ngs (1ntended solely for pur-
poses assoc1ated w1th a res1dence) wh1ch 1s owned and occup1ed
by him, or is be1ng constructed. 1n his name, as h1s personal
home and that said res1dence or aux1liary buildings be1ng so
Wired are not to be used or erected for rental purposes or for
resale to pre.sent or prospective purchasers.
Arf1ant understands that the electr1cal work author1zed by
the perm1t app11eq. for 1n connection with this artld.a.v1t, II1ust
be done onl:r by this artiant and that he cannot employ others to
assist with the electrical work but members of his 1II1med.1ate
faIlJily.
Dated tl11s on'!h clay of Y~tt ' 19!D...
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Subscr1bed and sworn to betore
t. h1s 0n7~~Y.o.t :12
^OO~ '--p ~
, 1911.
Notary Public, Winnebago County, Wiscons1n
MyComm1ss1on Expires: rs/--S/lqq()
.~
OWNER
ADbRESS
NATURE 01' WORK
..-2 ~-g'l
PERMIT' NO.
ELEC. CONTR.
TEM12.
~S
CIRC'S
SIGNS
INSP. ROUGBIN
~'l" COS'l' .p (J ~. .
::Rl<S .. . .....~. .. ...
SERVICE
PERMIT FEE
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DATE pD
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