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0099865 E
OSHKOSH ON THE WATER Job Address Contractor Service Volts Amps 416 KNAPP ST HOMEOWNER [~ New (~) Change (~) Tamp CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner Category No 99865 ROBERT A/MARY K SULTZE Create Date 07/22/2002 612 - Residential-Single Family Addition/Ret Plan Type I© Overhead (~) Underground I Circuits 0 Fixtures 0 Switches 0 Receptacles 0 Appliances Use/Nature of 2/18/03 wire addition Work Fees: Valuation Issued By: $700.00 Plan Approval $0.00 Permit Fee Paid $30.00 Date 2/18/03 Permit Voided The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the City of Oshkosh to perform said work. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address OSHKOSH WI 5490 - 5751 Telephone Number OSHKOSH ON THE WATER CITY OF OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD Job Address 416 KNAPP ST Contractor HOMEOWNER Service ~) New (~ Change O Temp Volts Amps 0 Owner Category Circuits Switches N o 99865 ROBERT A/MARY K SULTZE 612 - Residential-Single Family Addition/R Type O Overhead Create Date 07/22/2002 Plan (~ Underground Fixtures Receptacles Appliances Use/Nature of 2/18/03 wire addition Work Fees: Valuation Issued By: $700.00 Plan Approval $0.00 Permit Fee Paid $30.00 Date 2/18/03 [] Permit Voided The undersigned, in applying for an Electric Permit to perform electrical work within a single family home, owned and occupied as the principle residence by the undersigned, hereby acknowledges per City Municipal Code Section 11-22, that other individuals may not be employed to assist with the work described in this permit unless said individuals are licensed by the City of Oshkosh to perform said work. /~ In the performance of this v~ork I agree,~d~/e~m/all work~ursu, an~to/r~s governing the described construction. Signature .~/~.? '~~./"_/~.,~/ J'c~''''''''''''~ - ,// / ,,~ Agent/Ow[~.g¢ Address OSHKOSH WI 5490- 5751 Telephone Number Date