HomeMy WebLinkAbout2008-Building (siding)Thursday, May 22, 2008 1:10 PM Joe Hicks 920 779 4439
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Electric l.nst~il~atiun Vcri~ieation
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/~ /n~ (Electrical Contractor Name or Homeowner's Name)
(ll~ldressj (C'.ity) (State -
(Zip C:odz)
accept the resh(>nsibility to perfun„ the ~lcctt;c work as st1_tted belcJw, at tlJC fcJllowing Zddress:
(Address where work will be perfon-ned)
The nature of the work consists vl': (C:heck One or Describe the Nature of ~Ul/nrk)
Iteeonnection or new circuit for replacement healing Y1ant find/or A/C Condenser.
~,_ Reconnection or new eire>(it For rcpls~cetni;nt rlc~tric Water l~cater or power' vented
vv~llcr heater.
~Iteconnection of the Service }~'.r~tr~»oe C;ahle, 1VIeter 13ox, alterations to rece tacles
anti li. illtin lixtllr ~ilue to 5ldrng P
b ~ / soffit in5tal.lation. Note: New Service
Enlt-~tncc ('..abler wit ~~trirc~-scparate permit.
Kecorz~ection or new circuit lorthe replacement (rl.'other rernlanently wired
ahhliances /fixtures.
New circuit for the addition of A/C lu an r'nclivicluul c~vellin,~~ unit, including
regttireJ service electrical outlut~- Nvle: ffomenwYdE>r,~~ c~~TY! otalV do t61E'ir r~1~~Y1
elE-chic ort a san~lc~ fixrrtlly owner ucc>epied hvrnE. Work vn a cv~rilumirtiunz,
c.~t.aplcx, rental, fir' multi-u.,~e bttilcling would reyun'e c7 lii~en.sed Llec[r~ioct!
Cnn[r•actor.
. Other
'l~he value of l:his work i.s $_~~ ~ (r, (~ -
1 hereby vcri fy this work will be perfotlned in compliance with the License requirements o!'
Section 11-22 or the Oshl<:ush Municipal code and further verify the reearnlection /installation
will be done iu complian.ce with manufacturer and Electric code requ.ircazents.
(~Iglla rc of (_ Ol]~NBny C7 ('~i(•Cl- O!' ttOluCUwr10T) (Pant Name)
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