HomeMy WebLinkAbout0009149-Plumbing (kitchen sink)
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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9149
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of
Plumber
Dúe
I~~- I Block I Ward
OUTSIDE WORK
l Addition or Replat
NIW '"WEt WAtER STORMS FEES fEES ,ElAY S- SEWE' WAtER STORMS fEES
From Main to Curb Seplic Tanks From Main to Curb
nom Curb to Building Eleclric Pumps From Curb to Building
Repair
INSIDE WORK
NO. NEW UP- USED flES NO- NEW REP- USED FEES NO. NEW 'EP- USID fEES
- - -
Beth Tub ~ G..bage DlIpoAIs Catch Bulnl
-
Wuh Bum Dishwuben Conductors
- - - - -
W- Clooet Laundramúl Graue Cúeb Bulnl
L ~O( -
Sink Wúar Softeners Sump Pump II< Ejectors
Waler Heúers Sanitary Bubblers B.. and Soda Wules
Shower Baths Urinals
Floor Dralu Dental Cuspidors
- -
Laundry Tubs Sernce Sinks
IlDIIpections : :l¡tj~oo~: __::_:00: :~::_: ::=-=: Fee Verified, Receipted and Recorded Received Permit and Inspection Fees
---------------------------------------Ouilide ~----______oo_Sawar Fees
--------------------------------------_oo----Inside -- _~PooQ_____---_PIbg. Fees
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$______00____"'-__--00____--00___-------------______00_----- Dale +-p 76
In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by end
submit 10 ell statutes, city ordinances, and rules and regulations prescribed by the Boord of Public Works for the governmant of Plumbars.
It Is futher agreed by tho undersigned that no other uses will be mode of the above connections e~cept as hereinaller listed.
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"omblng In-_'
STATE OF WISCONSIN)
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WINNEBAGO COUNTY)
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(Name
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tvcu~
(Address)
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being first duly sworn on oath deposes and says that he is not
a licensed plumber. and t~at he has applied for a plumb1ng
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing work in a home owned and occupied by him. or a home
that is being constructed that is Qwned by him, and which will
be Qccupieci by him as his home when completed. That he i$ not
building said homB for the purpose of sa¡e.
This affidavit is made for the purpose of complying with
the prov1sions of the plumbing code of the City of Oshkosh and
the State of V!isconsin, which proviç!es that all plumbing work
must be done by a licensed plumber except that the plumbing work
may be done by one ~ho owns and occupies his own home providing
the installation co¡"pHes with ,the plumbing code of the City of
Oshkosh and thp St-òte of Wis consin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only by th1s affiant and
that he cannot employ others who are not licensed plumbers to
assist with the work.
Dated this -- day of ---- - ..... " ---' 19___,
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Subscribed and sworn tp before me
',- , /'
thi;i)?~.., da' of />../1A'/,_-' --' 19k.
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-~L. - , ~-
Notary Pù ie, wlnn~Œ~i'šconsin
My Commission, ExpLres:-L..¿..,-4.3.:.:-Ã----