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I Lot No. I Block I Ward I Addition or Replal
OUTSIDE WORK
Dato
NOW SEWn WATE. STORMS FEES 'EES .ELAY S. SEWE. WATE. STORMS FEEl
From Main to ClUb Septic Tanks From Main 10 Curb
Fmm ClUb to Bundlng Eleclric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
NO.
FEES
rlO.
NEW
.EP.
U$Eo
NEW
.EP. I U$ED
FEES
REP.
USED
"ES
L
-/
-y
I
(
,/
,/
/
/
/'-----
J.."'-
~
/ -----
Catch BullUl
Bath Tub
Garbage Db~
Dbhwuhers
Conductors
Wuh BulD
//
~I/
Greue Catch BullUl
Laundramats
Wator CION!
,..-
r--
I
Sump Pump Be Ejeclors
Water Softeners
---
Sink
¡/
Sanitary Bubblers
Bar and Soda Wasles
Water Hoaten
Showor Baths
Urino1s
I
/'
Denial Cuspidors
("""-
Floor Drains
Laundry Tubs
Inspoclions
- - - Servic:e Sinks
f Valuation of Ihe Work Herein Described
~_t?P_---~-----------------------------_._------
- - :-:::::::::_:::::::::::::::::-:--::::::::~::::::::-~:~:_.:~:::::~=
---_------0000---__0000 në-;ïÿ-T;~;;;;~;--n___-_.-----------n---
Fee Verified. Receipled and Recorded
Received Permit and Inspecllon F-
- nnnnnn---Sewar F-
J nj~__f'.e_-_nPIbg. Foos
D~;~-':~~; ;;y
;¡6L:~-/~---- 7-n:-/~-.__._-_._--____Outside
r;P'/ I'~-~~---- ------n_n..Inslde
---L~-.. ¿t.?-..¥--", ___-------00_"'_'------
------------__---_---_n_--Final OK
In the performsnca of this work the undersigned owner (or his authorired agent) of said premises and his authorired Plumber haraby agr.. to ba bounden by and
submit to all statutes. city ordina~. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
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