HomeMy WebLinkAbout0102420-Electric (family room)OSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 1662 DELAWARE ST
Contractor HOMEOWNER
Service ~ New O Change O Tamp
Volts
Amps 0
Appliances
No 102420
Owner SCOTT C/PATRICI LACOMBE Create Date 06/24/2003
Category 612- Residential-Single Family Addition/R Plan
] Type Q eye r_h_¢.a_.~ ~_ ._ U n_cl_e_r g~r_o__u n~d .......
Circuits 0 Fixtures
Switches 0 Receptacles
Use/Nature of =xisting Family Room wiring in the basement per correction notice
Work
Fees: Valuati~__~N ~5~0~.00 Plan Approval $0.00
Issued By: ~ ~[..~_~ ~
- [] Permit Voided
Permit Fee Paid $20.00
Date
6/24/03
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 perf..erma, nce of this Work I agree to perform all work pursuant to rules governing the described construction.
Slgnatur _ _ ~(..R.).Cj' ..... ~--¢y~_. f'~7_ ~ Date Agent/Owner
Address OSHKOSH WI 5490- 6725
Telephone Number