HomeMy WebLinkAbout0009244-Plumbing (fixtures)
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PLUMBING PERMIT - Oshkosh, Wisconsin Permil N~ 9244
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I Block __I Ward
I Lot No.
I Addilion or Replal
Dale
OUTSIDE WORK
NEW $lWEI WATER STORMS f... fEES RElAY S. SEWER WATER STORMS fEES
From MaIn 10 CUI'b Seplic Tanks From Main 10 Curb
From CUI'b 10 BuUdlnsr Eleclric Pumps From CUI'b 10 Building
Repair
INSIDE WORK
NO.
NEW
UP.
filS
NO.
NEW
IEP. I USED
"0.
"EW
REP.
fEES
USED
fEES
USED
Bath Tub
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Waler Sotleners
Sump Pump 81: Ejeclors
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¡.~Ü
Mi:
FlJC
Garbage DiBpoaa!a
Calch Bolm
Wub Buin
DiBbwobers
Conduclors
Greue Caleb Bolm
LaunMlUZUIIo
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Weier Cl_t
~
Sink
Wai8r Heale..
sanUary Bubblers
Bar and Soda Wasles
Shower BaIbII
Urinals
nOM DraIDs
Denial Cuspidors
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Laundry Tube
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Service Sinks
Fee Verified. Receipled and Recorded
Received Permi! and Inspaellon Feee
Valualion of Ibe Work Herein Described
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City T..""".,
In the performance of thi. work the undersigned owner (or hi. authorired agent) of said preml.es and his authorired 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 01 Plumbers.
It Is luther agreed by the undersigned that no other use. will be made 01 the above connections except as hereinalter listed.
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Plumbing In"*,,,'
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STATE OF WISCONSIN )
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WINNEBAGO COUNTY)
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(Adaress)
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be1ng first duly sworn on oath deposes and says that he is not
a licensed plumber. and that he has applied for a plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing wor'k in a home owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupied by him as his home when completed. That he is not
building said home for the purpose of sale.
. This affidavit is made for the purpose of complying with
the provisions of th¡; plumb1ng code of the City of O~hkosh and
the State of Wisconsin, which provides that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one v;ho owns and occupies his own home providing
the installation complies with the plumbing code of the City of
Oshkosh and the State of Wis condn.
This affi3nt understands that the Plumbing work authorized
by the pe:t;'mH applied for, must be done only by this affiant and
that he cannot employ others who are not licensed plumbers to
assist with the work.
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Dated this ~ day of
~7 .19/6.
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Subscribed and sworn to
My Com~ission Expires:
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