HomeMy WebLinkAbout0100490-ElectricOSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 2104 HICKORY LN Owner
Contractor HOMEOWNER Category
Service ~) New 0 Change 0 Temp I
Volts Circuits
Amps 0 Switches
No 100490
FREDERICK L PLONKA ETAL
612 - Residential-Single Family Addition/R
Type (~ Overhead
Create Date 03/28/2003
Plan
(~ Underground
Fixtures
Receptacles
4
20
Appliances
Use/Nature of ;FR / addition remodel ( Wiring to be done by the owners brother with help from Art's Electric)
Work
Fees: Valuation $700.00 Plan Approval $0.00
[] Permit VoidedI
Permit Fee Paid $30.00
Date 3~28~03
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.
Si InalureIn the performanCe, g ~/~ ~'J~' ~/~//~°f this work I, agree to perform all work pursuant to rules governing the described construction. Date
~' I ' ' - Agent/Owner
Address FREDERICK L PLONKA ETAL HARWOOD HEIGI IL 6065 - 4805 Telephone Number