HomeMy WebLinkAbout0002232-Electric (correct ronnex wiring in basement) '�..�.�
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AFFIDAVIT ftELATING TO SECTION 13.12 (c ) OF � GENERAL CRDINANCE
OF THE CITY OF OSHKOSH RELATING TO THE LICENSING OF ELECTRICIANS
AND PROVIDING PENALTIES
STATE OF WISCONSIN)
) SS
WIIVNEBAGO COUNTY )
��'/��s �����_' , / ��ti�'�`
Name Address
first being duly sworn on oath, deposes and says that he is not
a �laensed electrician in the City of Oshkosh and that he has
applied for an electrical permit to do electrical work in a
residencse and/or auxiliary bui].dings (intended solely for pur-
poses associated with a residence ) which �s oc�Tned 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 au�horized by
the permit applied for in connection with this affidavit , must
be done only by th2s affiant and that he cannot employ others to
assist with the electrical work but members of his immediate
fanily. .
Dated this day of �`J.� , 19 .
/ �
Subscribed and sworn to before
thi s � day of " �� �1 , 1��.
� l' '�� ;
Notary Public, W1 nebago County, tdisconsin
�?JY COMMISSIOfv EXP1R�i
My Commi ssi on Expi re s• .at3LY 20, �9s�