HomeMy WebLinkAbout0023664-Electric (wire porch)Eal
OSHKOSH A(
Lot
Type of Permit:
Nature of Work
PERMIT - APPLICATION AND RECORD CITY OF OSHKOSH N°_ 23664
Owner J� ' Id. No.
Block —
Building ❑ Electrical
PLUMBING CONTRACTOR
Bu. San. Sewer Curb to Bu
Bu. St. Sewer Curb to Bu
Water Service
Bath Tub ---
Wash Basin
Water Closet
Kit. Sink
Water Heater
Shower Bath
Plumbing Fees
Floor Drain
Garbage Disp.
Dish Washer
Laundry Mach
Water Soft.
Bubbler
l
Ward .ubdivision Zoning Parkland Dedication Fee Height Perm Flood Plain
Heating ❑ Plimbing ❑ Sign ❑ Wrecking ❑ Fence ❑ Pool ❑ Occupancy Permit Required 1 Insp. '111 - - Permit Date
Main to Curb:
Main to Curb
Urinal
S. Sink
Catch Basin
S. Pump
B & S Waste
Conductors
Total Fees
Sewer Fees
HEATING CONTRACTOR
Fuel: Gas ❑ Oil ❑ Elec. ❑ Solar ❑ Solid ❑
Conditioning Forced Air ❑ H. W. ❑ Elec. Base ❑ Steam ❑ Radiant ❑
System High Eff. ❑ Supplementary ❑ Air Cond. ❑ Ventilation ❑
Chimney: "A" ❑ "B" ❑ Direct Vent ❑ Con. Burner ❑ Flue Damper & E. 1. ❑
Calculated Heat Loss System BTU Rating
ELECTRIC CONTRACTOR
Electric Service: New
Description -Type
Fixtures
Appliances
talon +rinnl Cinnc
Switches
Ch
Temp.
Volts Amps
Recep's Circ's
BUILDING Use
General Cont.
Roof —_
Foundation
Size:
Height:
feet wide X feet long
Stories and Basement
Siding
Type of Construction
Square feet area
No. of Rooms —
Mason _
Carpenter
Architect
a
0
a
Inspections -
Footing Foundation
Electric Service R.I
Sewer
Final
above Grade
Water Service
Estimated Cost Fees Paid — Date - -_'�
TO THE BUILDING INSPECTOR: In accordance with Section 7 -18 of the Municipal Code of the City of Oshkosh, it is agreed that if work shall be
discontinued for a period of 30 days at any time for any cause after excavation work is commenced, a solid barrier, wall, or wire fence not less than
five feet in height shall be erected all around such excavation. Such barrier, wall orwire fence will remain in position until removal is approved by the
Building Inspector. X
In the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes, ordinances,
codes, and rules gove aii jg th ribed construction.
(Signed)
Address
Rv
(Authorized Signature)
Uwner
Phone Z53`7K'6f
M"—
Agent
AFFIDAVIT RELATING TO SECTION 13.12 (c) OF A GENERAL ORDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WINNEBAGO COUNTY )
Name Address
first being duly sworn on oath, deposes and says that he is not
a licensed electrician in the City of Oshkosh and that he has
applied for an electrical permit to do electrical work in a
residence and /or auxiliary buildings (intended solely for pur-
poses associated with a residence) which is owned and occupied
by him, or is being constructed in his name, as his personal
home and that said 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.
Afflant understands that the electrical work authorized by
the permit applied for in connection with this affidavit, must
be done only by this affiant and that he cannot employ others to
assist with the electrical work but members of his immediate
family.
Dated this 4 day of le /c—
Subscribed and sworn to before
this 4 day of ��'l��u,k4 19' •
Notary Public, Winnebago County, Wisconsin
My Commission Expires: ` - /IC /sZ