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HomeMy WebLinkAbout0102143-Electric (service change)OSHKOSH ON THE WATER ,Job Address 1927 HUBBARD ST Contractor HOMEOWNER Service [~ New Volts 110/220 Amps 100 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner NICHOLE J JOHNSON Category 634- Residential-Service Change ~)Change ~)Temp Type Circuits 0 Switches 0 No 102143 Create Date 06/12/2003 Plan Overhead (~ Underground Fixtures 0 Receptacles 0 Appliances Use/Nature of 9/12~03 service change Work Fees: Valuation Issued By: $850.00 Plan Approval $0.00 Permit Fee Paid $40.00 Date 6/12/03 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 - 0000 Telephone Number  CITY OF OSHKOSH No102143 OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1927 HUBBARD ST Owner NICHOLE J JOHNSON Create Date 06/12/2003 Contractor HOMEOWNER Category 634- Residential-Service Change Plan Service ~ New (~ Change (~) Temp i Type ~ O~/e~ea~d_ ............ (~ U.nd~e~gr~_°.~n~d__ Volts 110/220 Circuits 0 Fixtures Amps 100 Switches 0 Receptacles Appliances Use/Nature of i/12/03 service change Work Fees: Valuation Issued By: $850.00 Plan Approval $0.00 Permit Fee Paid $40.00 Date 6/12/03 [] 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 y ~~.~./ ~ ~_~~.., Date ,~2/~ Agent/Owner Address OSHKOSH WI 5490- 0000 Telephone Number