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Permit
N~ 9492
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¡ Lot No.
l_Addiiion or Replat
I Block I Ward
Dù.
OUTSIDE WORK
NIW SEwn WATER STORMS lEES lEES RElAY S. SEWER WATER STORMS lIES
From Main to Curb Septic Tanks From Main to Curb
~ Curb to BuDding Eleclzic Pumps From Curb to Building
Repm
INSIDE WORK
MD.
lIP. I USED I liES I NO.
USED
NEW
NEW
REP. I USED
FEES
"0.
"EW
REP.
FEES
Bùb Tub
Garbage Dis~
Cùch Baslus
/--------
Wuh BOlin
Dishwashers
Conductors
Wù.. CI_t
Laundramaie
Gre... CùcJ1 Bulus
SIIIIo:
f--
Wùer Softeners
Sump Pump 8< Ejectors
Water Heùe..
7
Bar and Soda Wastes
-If /,00
Shower Bùhs
Sanitary Bubblers
Urinals
noor DralDe
Dantal Cuspidors
Laundry Tubs
Senico Sinks
~1alion of the Work Herein Described
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Received Permit and Inspection Fe..
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Date 7h"Ä./~ (Í;
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Fee Verified. Receipted and Recorded
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City T,...~,.,---
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes. city ordinances. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the ebove connections except as hej;einaftor listed.
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