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0101649 E
OSHKOSH ON THE WATER Job Address Contractor Service Volts Amps 54 LAKE REST AVE HOMEOWNER [~ New (~) Change (~) Tamp CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner Category No 101649 TIMOTHY R/JENNI FRAN7 Create Date 05/20/2003 612 - Residential-Single Family Addition/Ret Plan Type I© Overhead (~) Underground I Circuits 0 Fixtures Switches 4 Receptacles Appliances &ir Compressor Use/Nature of SFR / Wiring for an attached garage and workshop (50A sub-panel from an abandoned Hot Tub circuit) Work Fees: Valuation Issued By: $500.00 Plan Approval $0.00 Permit Fee Paid $20.00 Date 5/20/03 Permit Voided 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. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address OSHKOSH WI 5490 - 7246 Telephone Number OSHKOSH ON THE WATER CITY OF OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD Job Address 54 LAKE REST AVE Owner Contractor HOMEOWNER Category Service ~ New (~) Change (~ Temp I Volts Circuits Amps 0 Switches No 101649 TIMOTHY R/JENNI FRANZ 612 - Residential-Single Family Addition/R Type (~) Overhead Create Date 05/20/2003 Plan (~) Underground Fixtures Receptacles 8 10 Appliances ~,ir Compressor Use/Nature of .~FR / Wiring for an attached garage and workshop (50A sub-panel from an abandoned Hot Tub circuit) Work Fees: Valuation $500.00 Plan Approval $0.00 [] Permit Voided j Permit Fee Paid $20.00 Date 5/20/03 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. In the performance of this work I agr,~fto pe?,p~ll work pursuant to rules governing the described construction. Signature /.~1~,~ ~ _~ Date ,~gent/Owner Address ~"¢'~ OSHKOSH WI 5490 - 7246 Telephone Number