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HomeMy WebLinkAbout0022225-Electric (service change) " \ L tA � ��� uNi � � N LN� c 3 � Q N � °� � `� � � `� O N � I � o� � � � N '�� � � 3 � � o �( ) � � � "''� y Q� V f0 �-' O I � $ Q � C � �3 0 � M z � p - � � �p d N ` I d � � � � \ ~ 3 = O � C i V) t � c •' � d � � � y N O +� � � o c t. C O O J Y � v� f3 � � N �� 7 t L � � � O.a g- i d d .. � � c Q. c � o `�._ } Q � � V I U�� Y �l � d � � � � � � y � N o � �' a� ,L°', �= 3 .. i t C � � � V p � a � � � •� � � C C � U � U � d E c � O O � `= � C +`• N pOa� C 2 N U � u� � s �o v 3 as � v ��, � � ,� � o cu � � v� o m � c . : � O � Z � U Q c LL W � lL � a-� 3 � C � �� 3o N � >, �°1�o�daQ � c ic .� � H �° 3 � t Y > a� �. O � O X � N C O � �� � � �( � L � � \ a� c.� � U � +. C . . (� I�� 7 (P 7 � � i � � d c �(n x � � LL fT � � N U 7 O � C � N cn � a� co� � p � : � � cC L� L �,� p�� m � � '�-p U � � 3 x i C ��L 'D f� N d � m � � �lV � � � � -°�� `�' c c � 'U' � o � � /� : 0 co a x c7� � � � o�� � a � � ��� ��� - � �� a, v O 3 °�� � � �,' � - ���— wa o �, o > �] `� Fp ln p� � ? . ❑ N � Z = V fD 'm m � j •: � o z �= o � � ' \ �n c U �� L � � � � a ° � � °o�- �. o � � Z �� � U o 3 �a �vL �, � g` Z ' N � c � � � N ❑ C � '� " � W�'-' � �'c�. � m ¢ cn � J C O 7 � � � � ow� t � p2~ p v -p` V� N m C3 � L�L (n = W �vwm � � �' Q m Q � � � O C ❑ ❑ O � � C � •-- W a. H _ � � ❑ � � � ) � o n a �' l . li � � c�a L � ❑ � � p a. U � °' � � a3i � � � � . V ( C � U U � m � � °> • 9i� W � O � � O O � (q ❑ S � � � N p� N � c� > C � � � � � � Z � � � ❑ ❑ V � _ � � +� L ._. a . � (� _ � � N H- ;� � ` m m � � n. S �, � �' Q � N Q- m °- � � c°n m o a�i o� H ❑ � � t � (� -�p a�i � � �j Q ' -� c � � � � ,tf o W J � a�i � cn U cn oo U � c��o � � � dc�j � E °� c Q � � d V L I � � 7 � _ � � td Y .� CD m � i U � � � N � 0 � p Q � Q � � O � � � m w � � � � >� �' � � � ❑ �' W � 7 � > -p L N W L ❑ � (n U U � � ,� c ;? � Q a ❑ 0 °o c`� N � � � � -o w ap � I li C7 � � � 00 � ' 0 � V p � o � U v Q � • � V IL 2 � Q � � m Z o ° ° � � Z : � o � � z a m p ai �- �n Q = L U 3 � a> � m Q ❑ a� V •" � rn � ° � i/� 3 � � � � i u � V � c U � c m 'c n = a o m � � � ~ m V c = m c Z � ,c°- � � � H � o � � � � f0 fl- � C U i � i (O '� �Jo o � � � � � � � � � � o � Q .. :� N � � W � � � ��. � = a � � � � � iu � � = � .c � w � o >. � c� .� a� a� x o. � o J � z amm � m � � Y � cn � x � c� cnc� c� wwoiiQ w . ' AFFIDAVIT F�ELATING TO SECTION 13.12 {c ) OF A GENEAAL ORDINANCE �'" OF THE CITY OF OS�OSH AELATING TO TI� LICENSING OF ELECZ'BICIANS AND P80VIDING PENALTIES STATE OF WISCONSIN) � ) SS WINNEBAGO COUNTY ) � f}-G L ���,� �� ��- �lS - L- /�t w � ��C � Name Address first being duly sworn on oath, deposes and says that he is not a 2lcensed electrician in the City of Oshkosh and that he has appl�ied Por an electrical permit to do electrical work in a residenae and/or auailiary 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. Affiant understands that the electrical work authorized by the permit applied for 3n connection with this affidavit, must be done only bq this affiant and that he cannot employ others to assist with the electrical work but members of his immediate facaily. Dated this � day of �� ��1 (��- , 19 ��'�. � � � ^ �'_``-' Subsar�bed and sworrl to before this � day of `�o-�-� - , 19�. � _ �,.Q�,�,o�� ��2 '�''.Q Notary Public, Winnebago County, tJisconsin � My Comm2ss�on Expires: �/ I���„ , �_ PERMIT N0. � ���� . APPL. DATE - � � ELEC. CONTR. - ., � OWNER �'{��� % ADDRESS �/ � � —' ��l-�'L���`" � NATURE OF WORK ELEC. SERV. �.N�Ei�1 ~v � '�- �, - '�- CHANGE TEMP. DESC. TYPE ? - �� ' `�>'�-=u�OLTS i��� �v AMPS /�cJ FIX' S RECEPT' CIRC'S APPLIANCES � - �� SIGNS , �z INSP. ROUGHIN SERVICE'="�'�> "-��"��5 FIN ���z�-"r� EST. COST s'Ol� -`-���PERMIT FE /.�%DATE PD.I,l7t'L?-� REMARKS